My Communicator | Summer 2023

Aging in Place

What is aging in place, or aging in community, and how is it beneficial?

How to Coordinate Care for Your Parents with Siblings

When it becomes clear that an aging parent needs caregiving, it’s uncharted territory for most adult children. Ideally, brothers and sisters rally together to recognize a parent’s needs and challenges, make plans to address them, and volunteer for essential caregiving tasks. But it doesn’t always work out that way.

Adult siblings may have clashing ideas about how much care a parent needs and who should provide it. They may have different perspectives on what their own roles should entail. Individual brothers or sisters may step up to take on caregiving responsibilities while others step back. In many families, sibling caregiving roles are never explicitly discussed.

This can all lead to conflict, “especially if the siblings disagree about what to do,” says Monica Macias, a social worker and director of the Program of All-Inclusive Care for the Elderly at

CalOptima Health, a community-based health plan serving lowincome people in Orange County, California. “This can blur the focus from where it needs to be—on the aging parent’s needs.”

But with some effort and careful communication, siblings can resolve these issues and pull together to support their aging parents in a way that’s supportive for everyone in the family. Below, family caregiving experts share insights and tips on how adult children can navigate this difficult terrain—and avoid emotional pitfalls that strain and damage sibling relationships. See COORDINATING CARE on page 6.

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Fatigue Among Older Adults

Nothing prepared Linda C. Johnson of Indianapolis for the fatigue that descended on her after a diagnosis of stage 4 lung cancer in 2020.

Initially, Johnson, now 77, thought she was depressed. She could barely summon the energy to get dressed. Some days, she couldn’t get out of bed.

But as she began to get her affairs in order, Johnson realized something else was going on. However long she slept the night before, she woke up exhausted. She felt depleted, even if she didn’t do much during the day.

“People would tell me, ‘You know, you’re getting old.’ And that wasn’t helpful at all. Because then you feel there’s nothing you can do mentally or physically to deal with this,” she said.

Fatigue is a common companion of many illnesses that beset older adults: heart disease, cancer, rheumatoid arthritis, lung disease, kidney disease, and neurological conditions like multiple sclerosis, among others. It’s one of the most common symptoms associated with chronic illness, affecting 40% to 74% of older people living with these conditions, according to a 2021 review by researchers at the University of Massachusetts.

This is more than exhaustion after an extremely busy day or a night of poor sleep. It’s a persistent whole-body feeling of having no energy, even with minimal or no exertion. “I feel like I have a drained battery pretty much all of the time,” wrote a user named Renee in a Facebook group

for people with polycythemia vera, a rare blood cancer.

“It’s sort of like being a wrung-out dish rag.”

Fatigue doesn’t represent “a day when you’re tired; it’s a couple of weeks or a couple of months when you’re tired,” said Dr. Kurt Kroenke, a research scientist at the Regenstrief Institute in Indianapolis, which specializes in medical research, and a professor at Indiana University’s School of Medicine.

When he and colleagues queried nearly 3,500 older patients at a large primary care clinic in Indianapolis about bothersome symptoms, 55% listed fatigue—second only to musculoskeletal pain (65%) and more than back pain (45%) and shortness of breath (41%).

Separately, a 2010 study in the Journal of the American Geriatrics Society estimated that 31% of people 51 and older reported being fatigued in the past week.

The impact can be profound. Fatigue is the leading reason for restricted activity in people 70 and older, according to a 2001 study by researchers at Yale. Other studies have linked fatigue with impaired mobility, limitations in people’s abilities to perform daily activities, the onset or worsening of disability, and earlier death.

What often happens is older adults with fatigue stop being active and become deconditioned, which leads to muscle loss and weakness, which heightens fatigue. “It becomes a vicious cycle that contributes to things like depression, which can make you more fatigued,” said Dr. Jean Kutner, a

professor and chief medical officer at the University of Colorado Hospital.

To stop that from happening, Johnson came up with a plan after learning her lung cancer had returned. Every morning, she set small goals for herself. One day, she’d get up and wash her face. The next, she’d take a shower. Another day, she’d go to the store. After each activity, she’d rest.

In the three years since her cancer came back, Johnson’s fatigue has been constant. But “I’m functioning better,” she said, because she’s learned how to pace herself and find things that motivate her, like teaching a virtual class to students training to be teachers and getting exercise under the supervision of a personal trainer.

When should older adults be concerned about fatigue? “If someone has been doing OK but is now feeling fatigued all the time, it’s important to get an evaluation,” said Dr. Holly Yang, a physician at Scripps Mercy Hospital in San Diego and incoming board president of the American Academy of Hospice and Palliative Medicine.

“Fatigue is an alarm signal that something is wrong with the body but it’s rarely one thing. Usually, several things need to be addressed,” said Dr. Ardeshir Hashmi, section chief of the Center for Geriatric Medicine at the Cleveland Clinic.

Among the items physicians should check: Are your thyroid levels normal? Are you having trouble with sleep? If you have underlying medical conditions, are they well controlled? Do you have an underlying infection? Are you chronically dehydrated? Do you have anemia (a deficiency of red blood cells or hemoglobin), an electrolyte imbalance, or low levels of testosterone? Are you eating

enough protein? Have you been feeling more anxious or depressed recently? And might medications you’re taking be contributing to fatigue?

“The medications and doses may be the same, but your body’s ability to metabolize those medications and clear them from your system may have changed,” Hashmi said, noting that such changes in the body’s metabolic activity are common as people become older.

Many potential contributors to fatigue can be addressed. But much of the time, reasons for fatigue can’t be explained by an underlying medical condition.

That happened to Teresa Goodell, 64, a retired nurse who lives just outside Portland, Oregon. During a December visit to Arizona, she suddenly found herself exhausted and short of breath while on a hike, even though she was in good physical condition. At an urgent care facility, she was diagnosed with an asthma exacerbation and given steroids, but they didn’t help.

Soon, Goodell was spending hours each day in bed, overcome by profound tiredness and weakness. Even small activities wore her out. But none of the medical tests she received in Arizona and subsequently in Portland—a chest X-ray and CT scan, blood work, a cardiac stress test—showed abnormalities.

“There was no objective evidence of illness, and that makes it hard for anybody to believe you’re sick,” she told me.

Goodell started visiting long COVID-19 websites and chat rooms for people with chronic fatigue syndrome. Today, she’s convinced she has post-viral syndrome from an infection. One of the most common symptoms of long COVID is fatigue that interferes with daily life, according to the Centers for Disease Control and Prevention. There are several strategies for dealing with persistent fatigue. In cancer patients, “the best evidence favors physical activity like tai chi, yoga, walking, or low-impact exercises,” said Dr. Christian Sinclair, an associate professor of palliative medicine at the University of Kansas Health System. The goal is to “gradually stretch patients’ stamina,” he said.

With long COVID, however, doing too much too soon can backfire by causing “post-exertional malaise.” Pacing one’s activities is often recommended: doing only what’s most important, when one’s energy level is highest, and resting afterward. “You learn how to set realistic goals,” said Dr. Andrew Esch, senior education advisor at the Center to Advance Palliative Care.

Cognitive behavioral therapy can help older adults with fatigue learn how to adjust expectations and address intrusive thoughts such as, “I should be able to do more.” At the University of Texas MD Anderson Cancer Center, management plans for older patients with fatigue typically include strategies to address physical activity, sleep health, nutrition, emotional health, and support from family and friends.

“So much of fatigue management is about forming new habits,” said Dr. Ishwaria Subbiah, a palliative care and integrative medicine physician at MD Anderson. “It’s important to recognize that this doesn’t happen right away: It takes time.”

Source: KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—the independent source for health policy research, polling, and journalism. Read more at kffhealthnews.org.

Coordinating Care

From page 1

A Common Challenge

It happens to many families every year—the parents are no longer able to be as independent as they used to be, and it falls to their adult children to arrange care and support. It’s an exceedingly common situation, but it’s far from easy, says Dr. Deena Goldwater, a geriatrician and cardiologist who serves as vice president of care delivery for Welcome Health, a Whittier, California-based primary care practice for people aged 65 and over.

“Caring for aging parents is nothing short of overwhelming. The term ‘sandwich generation’ describes this very well; it means that people are pulled in two directions, attempting to balance the needs of their children with the needs of their aging parents. Families face financial burden, emotional challenges, and difficult time demands,” Goldwater explains

There are some steps loved ones can take to ease the transition from family member to a caregiver, including:

• Getting the right documents in place.

• Asking for help.

• Learning the landscape.

• Communicating thoroughly and often.

Getting the Right Documents in Place

One of the first things that should be done, Macias says, is to get the appropriate paperwork in place. “Before an urgent situation arises, make sure you have your parents’ guidance documents completed, including a POLST and advance directive.”

She explains that a POLST has “different names in different states, but in general, it is a portable medical order that goes with a frail person as they are being treated so the doctors know what to do.” You can access more information about this process at the National POLST site, polst.org

“Another key document is an advance directive, which reflects what your aging parents’ wishes are,” Macias says. Also sometimes called a living will or health care proxy, “this simple, straightforward document allows them to express their wishes if they become incapacitated and unable to communicate. Advance directives are recognized in every state, and millions of Americans have them as part of their medical records.”

Asking for Help

If you need help navigating any stage of caring for an aging parent, Macias recommends reaching out to a local elder care agency or another provider who can support you. “Also, in many states, dialing 211 provides families in need with a shortcut through a maze of health and human services agencies. By dialing 211, those in need of assistance can be referred to or connected with appropriate agencies and community organizations,” Macias adds.

Goldwater says that enlisting the services of a geriatric care manager can help if you’re overwhelmed. “These care managers are trained to help families navigate the complexity of health situations. They are also incredibly helpful with identifying community resources to tap into to help an aging parent.”

Learning the Landscape

Another challenge many adult children face when an aging parent needs care is the range of options available. Dr. Michael Tehrani, a geriatric physician with Brand New Day HMO, a California Medicare Advantage plan, recommends researching what care options are available locally to see what might match with your parent’s needs and values. Doing this legwork before the parent becomes incapable of expressing their own wishes is key because their preferences can help guide your choices.

For additional support, Tehrani recommends working with “a trusted placement agent. A good placement agent is like a matchmaker. They know the different types of communities well, get to know the loved one well, and match them to the community they feel is the best fit.”

And ask lots of questions to make sure you understand your options and obligations and to stay a part of the process.

Communicating Thoroughly and Often

As a parent’s condition changes and care decisions need to be made, it’s important the adult siblings keep each other updated as much as possible on the situation—what to expect, tasks needed, and requests for help. This communication and cooperation, however, can be a major caregiving challenge. “Coordinating care for aging parents takes a village—one person cannot do this alone,” Macias says.

To stay organized and keep siblings in the loop, you can use informal channels like quick calls or texts or turn to systems created to enhance family caregiving:

• Apps. Create a free, personal CaringBridge website that

everyone—parents, siblings and extended family—can use to instantly stay in touch and up to date. Often designed by caregivers themselves, online apps, such as CareZone, Lotsa Helping Hands, and Caring Village, help you manage the countless aspects of caregiving.

• Virtual family meetings. When crucial caregiving decisions must be made, it helps to have everyone together and focused. Family Zoom meetings or conference calls are opportunities for siblings to hear each other’s voices and interact from afar.

• Checklists. Spelled-out tasks and responsibilities can bring clarity and reduce friction. You can download a variety of caregiving checklists online.

Miller, one of six adult children, frequently took lengthy road trips back and forth from her Georgia home to help her parents, then living in Florida. “I found myself squeezed: caring for kids and aging parents while working on a full-time job,” she recalls. “My husband was also caring for his mom with lung cancer. We were losing our minds. It was the hardest part of my life, to date.”

For a time, Miller and her siblings relied on a CaringBridge website to document their parents’ health status and enhance family-wide communication.

We Care. You Care.

SourcePoint’s

When talking about communication, it’s important not to overlook that your aging parents will have preferences and should be involved in the decision-making process as much as possible. Macias encourages adult children to “ensure that you’re having conversations with your aging parents regarding their wishes and reminding yourself that these are their wishes. Often, we see siblings in disagreement, and then documents get changed based on the siblings’ wishes, not their aging parents’ requests,” she explains.

SourcePoint’s

Goldwater agrees that it’s important to talk with your parents early on to understand their values so you can make decisions in line with their wishes. “Often, siblings find themselves caring for parents who are no longer able to make decisions for themselves due to diseases, such as dementia or stroke. Understanding your parents’ values, and things that matter most to them, eases the burden of challenging or complex medical decisions that will inevitably arise.”

Prepare for a Daunting Responsibility

You don’t realize how much goes into caregiving until you’re already immersed halfway up to your elbows with multiple responsibilities to meet.

“It was like a mudslide to see my parents’ health declining,” says Elizabeth B. Miller, a certified caregiving consultant, founder of the Happy Healthy Caregiver online community and blog and host of the Happy Healthy Caregiver podcast on the Whole Care Network. Both of her late parents had multiple and debilitating chronic health conditions.

“Keeping everybody in the loop is its own job,” Miller says. “CaringBridge really helped with that. It helped also with sharing memories and photos with our family members.” As her father became severely ill, CaringBridge gave Miller’s mother a place to channel her worries and thoughts. “That just helped her process what was going on, and being able to connect.”

When Miller’s father passed away in 2014, her ailing mother’s situation at home became untenable. “We were in a real pickle situation where we had to move my mom,” Miller says. “She could not stay in the place.” Her mother needed help, the financial situation was worse than expected and the family realized, “We are going to have to make some decisions—and fast. It was a nightmare figuring it out.”

Sharing care among busy siblings was like putting together a puzzle, says Miller, who now coaches caregivers in similar circumstances. Among other resources, her Happy Healthy Caregiver website offers worksheets, including one that spells out myriad caregiver responsibilities with the second column left blank for whichever sibling is assigned to undertake each one. An only partial listing of caregiving tasks includes the following:

• Administering medications.

• Communicating with the long-term care facility.

• Coordinating occupational and physical therapy.

• Individual household chores.

• Meeting with attorneys, purchasing clothing, and completing administrative and logistical tasks.

• Replenishing medical and personal supplies.

• Scheduling doctor’s appointments and transporting them.

Many additional tasks also likely need to be completed, depending on the situation.

See CAREGIVING FROM AFAR on page 8.

Caring for a spouse, parent, or other loved one takes a great deal of time, effort, and hard work. And you don’t have to do it alone!

caregiver support offers a variety of free resources and dynamic programs

Caregiving from Afar

From page 7

How to Help Out From Afar

Some caregiving tasks must be performed in person, but many can be done from a distance. If you’re a long-distance sibling, these are just some of the ways you can make a meaningful contribution to family caregiving:

• Helping with financial management.

• Filing insurance claims.

• Engaging in FaceTime chats or phone calls with parents.

• Researching long-term care options.

• Dealing with Medicare/Medicaid issues.

• Ordering medical and personal supplies.

Thoughtful gestures matter, too. “There are many things a long-distance caregiver can do to help,” Miller says. “Pay for lawn care or send DoorDash or a gift card.”

Primary Caregiver in Charge

Primary family caregivers tend to emerge when an aging parent becomes vulnerable. Parents may have already singled out an adult child to act for them. Or, a son or daughter simply sees that a parent needs help and so naturally fills the void. Whether it’s researching long-term care facilities, hiring at-home caregivers, checking in on parents, supervising their medication, or providing hands-on care, somebody has to do it.

“There’s a saying, both among caregivers and among senior living staff and medical professionals, that there’s always one,” says Liz O’Donnell, founder of Working Daughter, an online community for women balancing eldercare, careers, kids, and more. “So, whether you’re an only or one of eight siblings, there tends to be one adult child who takes the lead. And in my case, it was me.”

Navigating Sibling Dynamics

As adult children struggle to adjust when their previously independent parent needs assistance or caregiving, sibling dynamics can move in unexpected directions.

“If you are the one who’s designated by your parents—they asked you to be the health care proxy or they asked you to be the power of attorney—then own the role,” says O’Donnell, who is also the author of “Working Daughter: A Guide to Caring for Your Aging Parents While Making a Living.” “Your parents picked you for a reason. It may not feel fair or comfortable to everybody else in the family, but for whatever reason, they picked you. So, don’t be afraid to be in charge. Somebody has to be in charge.”

Cooperation may become difficult as family ties are tested in entirely new ways. Sibling hierarchies can reassert themselves with oldest/youngest/middle child dynamics. Adult children filling the lead caregiving role may take feedback from long-distance or less-involved brothers or sisters as not-so-constructive criticism.

“The way I tell people to operate in that role, if they’re choosing to try to maintain healthy relationships with everybody involved, is high input/low democracy,” O’Donnell says. “So, if you want to gather input from the other siblings in the family—ask them what they’re seeing, what they think—that’s great. It’s great to feel heard as a sibling who isn’t the one who’s in charge or wasn’t assigned proxy. But, ultimately, that sibling who is the proxy or the power of attorney has to make the decisions.”

Balancing Unequal Roles

Carol Bradley Bursack, a columnist, blogger and author of “Minding Our Elders: Caregivers Share Their Personal Stories,” interacts with family caregivers across their country and responds to their heartfelt concerns.

An issue that resonates strongly for Bradley Bursack’s audience is when other family members offer seemingly self-serving reasons for staying detached from caregiving or not visiting, whether the parent is living at home or in a long-term care facility. She says these common excuses are often the most grating: I don’t have the time. I don’t have the money. I can’t bear to see Mom/Dad like that.

In terms of time, “somebody who has both young children plus needy in-laws, maybe their own health issues, and a busy job or something—the idea that they’re going to physically help in any way, especially if there’s a distance, might be unrealistic,” Bradley Bursack says, adding that this issue is something to ask about.

More often, she explains, the issue is a lack of time among all of the family members. “So, we can be better off saying: ‘OK, I live closer; I’m in my parent’s community. I will do my best to do handson managing. You take over the financial thing.’” Many scheduling and other time-consuming chores can be done online, she notes. “So, you can assign things or say: What can you do to help?”

Lack of funds can be a valid reason not to chip in, at least financially. “Some people, quite frankly, just have better-paying jobs than others,” Bradley Bursack says. Traveling to visit or helping to pay for a parent’s supplies may not be feasible for some children. However, she adds, that person can still take on important responsibilities, such as online research or filing a parent’s income tax.

When a parent is losing ground—physically, cognitively or both— it’s hard for adult children to witness, and some shy away. “They hate to see this decline,” Bradley Bursack says. But, she adds, involved caregivers may wonder: “They don’t see it’s ripping our guts out, too?”

Some people may be more emotionally equipped to handle a parent’s physical or mental decline than others. It can be helpful to seek out support, such as individual counseling or joining a support group for long-distance caregivers.

Play to Each Sibling’s Strengths

Almost everyone has what it takes to pitch in with at least one or two essential caregiving aspects.

“Play to your strengths,” O’Donnell says. “We all have them. We’re all different as siblings, so any way you can farm tasks out and everyone has a role, then there’s less frustration.”

One sibling may be quick to forge ahead with communicating with health care providers, making decisions, mobilizing resources, and working out caregiving logistics, says O’Donnell, who instinctively took on those roles along with hands-on caregiving. Eventually, she realized it was “magical thinking” to expect her sisters to work at her pace or to look at matters exactly as she did. Instead, one sister took on long-term, sensitive projects. And the other put her talkative nature to work.

“I was never the daughter who wanted to call my parents every night,” O’Donnell says. “So, my sister’s role became: You call them and chat with them every night. And if you hear anything, feed it back to me. But I’m going to go all day long and meet with the elder law attorney, and talk to the doctors, and run the errands. And at the end of the night, I want to go home and be with my husband and kids. I don’t want to be on the phone.”

Walk in Your Sibling’s Shoes

“Families are more dispersed now than they have ever been,” O’Donnell says. “Tensions can easily arise between the local caregiver and the long-distance caregiver.”

Clearing the air and some mutual empathy can make the way smoother. “It’s really helpful if those two roles can have some compassion for each other or really try to listen to each other,” O’Donnell says. For instance, the local sibling may become gradually accustomed to a parent’s physical and mental changes —but it’s an abrupt shock for the other sibling.

“Maybe the long-distance caregiver comes into town for the holidays and observes a massive decline, but the local caregiver isn’t seeing that decline as much because they’re seeing their parent every day,” O’Donnell says. “Or, they’re totally aware of it, but they’re doing the best they can, and the long-distance sibling comes in and says: ‘Whoa, Mom’s really looking frailer than she

used to.’ The local caregiver can take that very personally.”

Instead, O’Donnell advises, try to not take it personally. “Maybe it’s just a really helpful observation—or not helpful, but their observation,” she says. “So, as much as you can, respect the other person needing to have a point of view.”

What Works

Nobody plans ahead to become their parents’ caregivers, and it takes time to make sense of the situation. Caregiving experts who’ve been there point to helpful attitudes and actions:

• Playing to each sibling’s strengths.

• Fostering compassion for each sibling’s situation.

• Keeping communication going so family can stay informed.

• Allowing non-dominant caregivers to express themselves.

• Consulting with professionals, such as an elder-care attorney or geriatric care manager.

• Engaging in self-care and self-preservation—putting on your own life jacket first.

• Making peace with how it is.

Even if you’re disappointed or frustrated with a sibling’s response, it may be worthwhile to stem the emotional draining and move on. “Just try listening to them,” Bradley Bursack suggests. “Listen well, and listen with an open heart. And try not to remember grudges.”

Connecting as a Family

How will you and your siblings feel about one another during the caregiving period and in the aftermath?

“If you can get to the point that none of the dynamic really matters, all that really matters is: There’s an incredible opportunity to show up for someone who’s vulnerable, and you can see that caregiving is something that can give to you, not take from you, then that’s where you can really start to connect as a family,” O’Donnell says.

Caregiving has made her family even stronger, Miller says. “My parents had that ingrained in us. ‘Blood is thicker than water’ and ‘nobody’s going to love you like your family.’” Now, she says, “we pretty much feel like we can conquer anything.”

Caring for the Caregivers

Lastly, it’s important that adult children caring for aging parents take some time to look after themselves. Goldwater notes that “similar to raising children, caring for aging parents can be deeply rewarding but also incredibly challenging. Be sure to find time to take care of yourself.” Make time for exercise, mindfulness, or meditation practices to reduce stress.

First published in U.S. News & World Report. Read the original article at health.usnews.com/senior-care/caregiving/articles/ coordinate-aging-parents-with-siblings.

Aging in Place

From page 1

Aging in place is the concept of staying in one’s own home as one ages. Over time, many changes accompany retirement age, both positive and negative. On the one hand, people naturally become more comfortable with familiarity and routines. Aging in place makes it easier to adjust to the changes that come with aging, such as reduced mobility or declining health.

On the other hand, sudden changes like moving into an assisted living facility can be a big shock to the system. For many older adults, having strangers coming in and out of their homes daily can feel unsettling. By contrast, aging in place allows older adults to maintain their independence while still receiving support from caregivers like family members or health care workers. This can help them avoid the stress and anxiety associated with new surroundings or unfamiliar people.

According to an AARP survey, three out of four adults over the age of 50 want to live in their current homes and communities as they age. Many said they would modify their homes to make aging in place possible, including adding grab bars in the bathroom or a ramp outside. Therefore the movement to support aging in place is gaining traction as more and more people recognize its benefits.

How Does Aging in Place Differ From Nursing Home Care?

The main differences between aging in place and nursing home care are the level of support provided and the independence allowed. Nursing home care is a more comprehensive form of care

that includes around-the-clock medical support and supervision. This type of care is typically necessary for people with severe health conditions or complex needs.

Aging in place allows individuals to age at home with the support of family, friends, and caregivers. This way, they can handle most of their needs independently while still getting help with things like cooking, cleaning, and transportation—not to mention handling personal needs, such as online therapy or telehealth.

This is the preferred option for many people as it allows them to maintain a sense of autonomy and control over their lives. It also allows them to stay in their own homes, which can be a great source of comfort as they age.

Why is Aging in Place Important?

Aging in place is an essential concept for many reasons. First and foremost, it provides older adults with a sense of comfort and familiarity, promoting greater well-being. As people get older, they often value predictability and continuity, and staying in one’s own home best allows them to preserve these things. Additionally, maintaining a familiar space helps minimize stress that often comes with moving or making major life changes.

Aging in place also provides great flexibility for caregivers. By being around for caregiving, family can be more involved in making decisions about treatment plans or taking on chores like grocery shopping and housekeeping. Meanwhile, older adults and their family members alike get to enjoy the benefits of social connections associated with this caregiving.

How To Age in Place at Home

There are a few key things that you can do to age in place successfully. First, it’s essential to be proactive about your health, including eating a balanced diet, staying active, and getting regular check-ups.

Additionally, you’ll want to create a support network of family and friends who can help you with caregiving tasks like transportation, groceries, and light housekeeping. You should also keep a list of emergency contacts for these loved ones in case of any unforeseen issues.

Finally, staying active and engaged in your community is a good idea. This can help you maintain a strong social network, which is essential for both your mental and physical health. There are many ways to stay active, such as joining a senior center or participating in local activities.

Does Aging in Place Require Remodeling?

Depending on your mobility and physical ability, you may need to make some accessibility upgrades to your home to age in place successfully and safely. This might include:

• Installing a wheelchair ramp.

• Installing an easily accessible bathtub.

• Adding handrails in the bathroom or around the house.

• Widening doorways to accommodate walkers or scooters.

These changes can help you maintain independence and live comfortably at home as you age. Beyond simple changes such as these, you may also want to consider more significant renovations, such as adding an elevator or expanding your living space.

Of course, any major changes should be discussed with your family and caregivers to ensure that they are feasible and affordable. Ultimately, the goal is to make your home a safe and comfortable place to live.

Mental Health Benefits of Aging in Place

Aging in place has been shown to have several mental health benefits. However, it isn’t a standalone concept. In an AARP report, aging in place was found to be most successful when it was combined with other programs, such as liveable communities like those that provide social interaction, education, and support. While aging in place isn’t the same as these programs, the research shows that they share many of the same benefits.

In other words, while aging in place can be a great way to maintain your independence, staying socially connected and engaged in your community is also

important. This combination of factors has improved mental health outcomes for older adults, such as:

• Increased life satisfaction: Many people feel happier and more content with familiar routines and surroundings.

• Greater self-esteem: By functioning without depending on others, many feel a sense of accomplishment and greater self-worth.

• Reduced anxiety and depression: Many people feel calmer and less anxious with a stable and comfortable living situation.

• Better cognitive function: With a

stimulating environment, people are more likely to engage in activities that keep their minds sharp.

Additionally, with a happier mental state, it’s easier to maintain a healthier lifestyle overall. Not to mention that the community around them benefits when aging in place is supported. Everyone can benefit when older adults stay in their homes and are active in the community as they age.

If you’re considering aging in place, talk to your family and doctor to create a plan that’s right for you.

Source: Aging.com.

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MANOS, MARTIN & PERGRAM CO., LPA Attorneys at Law

Client Focused, Client First Since 1951

50 North Sandusky Street, Delaware, Ohio 43015-1926 Phone: 740-363-1313 Fax: 740-363-1314 email@mmpdlaw.com; mmpdlaw.com

Where you want to be!

SourcePoint’s in-home care services are designed to help Delaware County adults 55 and older remain living safely in their own homes with independence and dignity. We provide direct access to in-home services, as well as referrals to other community resources that can help. Eligibility for in-home care services is based on need, not income, and services are available on a sliding fee scale.

From adult daycare to chore services, emergency response systems to Meals on Wheels, medical transportation to respite care—SourcePoint’s in-home care services are coordinated especially for you.

Learn more at MySourcePoint.org/care or call 740-363-6677 to speak with an information and referral specialist today.

| 740-363-6677

Paying It Forward with Meals on Wheels

At SourcePoint’s volunteer appreciation dinner in April, Bob and Sue Postle, pictured at right, were recognized for reaching the milestone of 20 years of service as Meals on Wheels drivers. Sue had discovered the value of the home delivered meal service during her 16 years as a caregiver for two relatives. “Meals on Wheels volunteers made my life so much easier; I couldn’t have gotten by without it.” While 20 years is a long time to return a favor, the Postles recognized they may be paying it both backwards and forwards.

According to Meals on Wheels America, the membership organization that supports senior meal programs, the fastest growing segment of the population in America is the 85+ age group, and the number of citizens over age 60 is projected to double in coming decades. The national Meals on Wheels program’s 2-million-strong volunteer pool is not adequate to meet growth in many communities—including Delaware County.

SourcePoint’s Meals on Wheels never missed a beat during the pandemic and in 2022, both its home-delivered meals and community cafe programs grew by 20%. In 2023, growth through April was up 17% over 2022. “We are serving more clients than ever,” says Karen Pillion, SourcePoint’s nutrition program administrator. “Which means our routes are growing and the only way we have to control route growth is by dividing them into smaller routes.”

In the last year, four new meal routes were created after dividing existing routes, two in southern Delaware County and two in Sunbury. Each new route requires at least five new volunteers. “We would like to divide more routes, but we can’t until we have more volunteers,” said Karen. Increasing populations bring with them increased traffic, further complicating the creation of manageable meal routes. “We want to give the volunteer the best possible experience, and that means making sure routes are both a reasonable distance and timeframe.”

One Meals on Wheels volunteer, Carol Rohde, knows about paying it forward. She and her husband, Bob Backus, had been delivering meals for about 10 years when they suffered simultaneous health crises. For a short period, they became meal recipients instead of meal deliverers. “I couldn’t have gotten through that time without the help of other volunteers.

Having been a meal driver, I knew how valuable the service would be for us during that time.” Once the couple regained their health, they were back on the road, delivering meals to their beloved senior clients on their meandering countryside route.

Volunteers deliver a hot lunch, an optional cold dinner, provide a safety check, and a friendly greeting to homebound seniors. Most routes pick up and drop off at SourcePoint, except for Sunbury routes, which have the option of picking up/dropping off at Rainbow Place Apartments. While no client has ever missed a meal due to lack of volunteers, staff frequently step in to cover meal routes when a volunteer calls off with short notice. Volunteers needing to cancel their scheduled service just leave word of the dates they will be away and staff members handle finding a substitute. Meal drivers are also offered mileage reimbursement at a rate of $0.66 per mile for their route to offset the cost of volunteering.

SourcePoint is more than just the start and end point for volunteer meal drivers. The facility houses a commercial kitchen where meals are handcrafted by chefs and packed by volunteers. Seven volunteers per day volunteer once a week, Monday through Friday from 7 to 11 a.m., packing 800 meals into trays.

Meanwhile, SourcePoint’s on-site lunch spot, Cafe 55, has seen growth from serving an average of 111 diners a day pre-pandemic to 150 diners post-pandemic; an indicator that the cafe’s focus on improving the dining experience by adding made-to-order salads, beverage service, fresher food, prepackaged silverware, and more menu options has been a success. Volunteers provide customer service in the cafe in two-hour shifts between 10 a.m. and 2 p.m., Monday through Friday.

“There would be no home-delivered meals for local seniors or community cafes to combat isolation without our volunteers.” Karen Pillion said. “The success of SourcePoint’s Meals on Wheels program is on the shoulders of our community members to step up and pay it forward.”

We are all growing older or, after all, at least love someone who is. For information about volunteering as a meal driver, meal packer, or cafe host, contact SourcePoint’s volunteer recruiter, Jill Smith at 740-203-2368 or jill.smith@MySourcePoint.org

We Need to Talk...

Aging can bring about changes that may deteriorate a person’s ability to continue to drive safely. These changes may make it obvious to an older adult that it may be time to retire from driving. Sometimes though, this is not the case and that older adult, who may be your spouse, parent, sibling, or friend, does not realize they are a risk to themselves and others. The suggestion to surrender one’s driver’s license evokes emotions of loss, anger, or embarrassment in some older adults. These emotions make it a difficult conversation to have with a loved one.

It is important to remember that getting older is not necessarily a reason to give up driving. After all, driving serves as a source of independence and even a

source of pride. But decreased reaction time, vision problems, and hearing decline are associated with normal aging. These factors may lead you to question a loved one’s driving abilities. The key for you is to not make assumptions based on age alone, but to observe your loved one as a passenger. If you have concerns, run an errand with the driver to gauge their response time and driving proficiency. If you see ‘red flags,’ broach the conversation later, not during the drive. Gently express your concern for their vulnerability on the road. Point out how their impaired driving proficiency hinders their ability to avoid risks posed by other more aggressive drivers. Framing the conversation without blame and approaching it as an ongoing dialogue will

tend to increase the receptiveness of your loved one.

Finally, offer alternatives to your loved one who surrenders their driver’s license. Be ready to offer resources and support to help your loved one maintain their healthy independence.

The SAFE Delaware County Coalition aims to keep all seniors driving safely. We offer a variety of free driver safety programs at SourcePoint. July features roundabouts, focus groups on older driver assessment and medication effects, and CarFit. August features an occupational therapist on safe driving and in September, experts present “We Need to Talk,” addressing driver license surrender. Learn more and register at MySourcePoint.org/EC.

FROM THE SOURCE

The latest news, programs, and resources available at SourcePoint.

Helping You Thrive After 55

From hundreds of programs available on-site at our enrichment center to classes offered at partner organizations in your neighborhood, there’s something for everyone! On this spread are just a few of the summer highlights.

Don’t forget—a community pass to SourcePoint’s enrichment center is available at no charge to Delaware County residents ages 55 and better. Guests have access to numerous free programs. Select programs, including some fitness, arts, and education classes, require a fee.

Plus, scholarship funds are available to help qualifying individuals with program fees. If you or a loved one could benefit from participating in community programs, it’s easy to apply! You can learn more, join us, apply for scholarship funds, and register at MySourcePoint.org/EC or call 740-363-6677.

Express Yourself with the Arts

COMMUNITY MUSIC FESTIVAL AND ART OPENING

Thursday, Aug. 24, 5–8 p.m.

Come enjoy music and art! Check out those demonstrating the arts, as well as the exhibits featuring these creative groups: woodcarving, Handwork with Friends, Life’s A Stitch, photography, and member art. Sponsored by Mobility City.

TIE-DYE T-SHIRTS

Tuesday, July 18 and Wednesday, July 19, 3–5 p.m. Celebrate summer by making your own unique colorful tiedye shirt. Bring your own 100% cotton t-shirt or another garment to tie dye. Wear old clothes! Fee: $15.

BIG CANVAS SPIN ART

Friday, Aug. 11, 1–3 p.m.

If you have seen our spin art machine, you know how much fun it is to add paint to a spinning card and watch as a work of art emerges! This class will take spin art to a new level using a 16x20 canvas. Fee: $30.

Enrich Social Connections

COMMUNITY MOVIE SCREENING AND Q&A WITH DIRECTOR MIKE EDWARDS

Thursday, July 13, 3–5:30 p.m.

“Searching for Augusta: The Forgotten Angel of Bastogne” is a true story that begins with two nurses, Renee LeMaire and Augusta Chiwy, treating patients in the Bastogne aid station. Renee was killed on Christmas Eve and became famous as “The Angel of Bastogne.” Augusta’s story was lost to history for 65 years. Her story is one of great courage and heroism in the face of racial discrimination.

COMMUNITY MUSIC FESTIVAL

Wednesday, July 19, 5–8 p.m. What do you get when you have warm weather, food trucks, live music, and friends all in one place? A summer music celebration! Come enjoy the music of the MEEK Quartet and Of Sound Minds. Ciao Gelato and Pitabilities food trucks will be on-site. Bring a camp chair as we will be outside, weather permitting. Sponsored by Mobility City.

Engage Fitness & Wellness

BARRE FITNESS

Thursdays, 11–11:45 a.m.

Beginner-advanced. A total-body, muscle-endurance workout. Barre targets small movements using high repetitions with light weight that focuses on arms, legs, glutes, and core. Improve balance and build strength while developing agility using weights, resistance bands, and balls. Fee: $40 for a one-time per week series.

HIIT SQUAD

Mondays or Wednesdays, 5–5:45 p.m.

Beginner-intermediate advanced. High Intensity Interval Training (HIIT) is a fun, challenging way to build strength, increase endurance, and torch fat. Using bodyweight, plyometrics, and weights, redefine your body and well-being, increase metabolism, and get fit fast! Fee: $40 for a one-time per week series.

Empower Transitions in Aging

INSURANCE:

MARKETPLACE ASSISTANCE

SourcePoint is now helping Delaware County residents aged 55-64 seeking health insurance through Ohio Healthcare Marketplace. Our insurance specialists are certified assisters, trained to provide in-person and phone-based support to help consumers narrow their plan options on the Affordable Care Act’s health insurance marketplaces.

GOOD DEEDS

Thursday, Aug. 10, 2:30–4:30 p.m.

The probate process can be time consuming and necessitates the assistance of an attorney. Learn how to avoid the need to probate your home and vehicles. Presentation by Judge David A. Hejmanowski, Court of Common Pleas; Melissa Jordan, Delaware County Recorder; and Natalie Fravel, Delaware County Clerk of Courts. If you would like to review your deed at this event, email mjordan@co.delaware.oh.us with “Aug. 10 SourcePoint 2:30pm” in the subject line, along with the names and address on any deed filed in the county that you would like printed. Include the approximate year it was filed.

BRAIN LONGEVITY: THE 4-PILLARS OF ALZHEIMER’S PREVENTION

Thursdays, Sept. 7, 21, Oct. 5, and 19, 1:30–2:30 p.m., and Nov. 2, 1:30–3:30 p.m.

This series on natural methods for prevention of Alzheimer’s disease and other dementias consists of an introductory session and four workshops. Whether you are concerned about dementia for yourself or are a caregiver for someone with dementia, these seminars will have information to help you reduce stress and lower your risk of dementia.

Enhance Learning

BOOK CLUB: FICTION ADDICTION

Third Wednesday of each month, 1‒2 p.m.

Join member Annette Schorr to read and share your thoughts and hear others’ perspectives. The first meeting, on July 19, is to organize the group and share your favorite book.

BIRDING: ALUM CREEK BIRDS

Tuesday, Aug. 1, 1‒2 p.m. at Alum Creek Visitor Center, 5905 Lewis Center Road.

Meet for a talk on local birds from a park ranger intern.

Explore Our World with Trips

BILLY JOEL & STEVIE NICKS

Saturday, Aug. 5, 5 p.m. bus departure, midnight est. return. Billy Joel and Stevie Nicks are co-headlining the Two Icons, One Night Tour. Nicks is the only woman to be inducted into the Rock and Roll Hall of Fame twice, and he’s sold more than 160 million records around the world. Now, watch the Piano Man and the Reigning Queen of Rock perform together at The Ohio State University’s Ohio Stadium. Seats in C Deck. Elevators available. Activity Level 2. Registration through July 22. Fee: $140 for members; $160 for non-.

LEBANON

MASON MONROE RAILROAD & LUNCH

Friday, Sept. 22, 8:30 a.m. bus departure, 4:30 p.m. est. return. Join fellow travelers for a train ride on the LM&M Railroad’s Turtle Creek Valley Flyer. Savor lunch at the Golden Lamb followed by some free time in charming Lebanon. Please note: Due to the historic nature of the railroad, it is not handicapped accessible. Activity Level 2. Registration through Sept. 8. Fee: $95 for members; $115 for non-.

We love our volunteers! Join the winning team that makes our community the best place to thrive after 55.

SourcePoint’s volunteer orientation includes a presentation, tour, and the chance to sign up for various areas, from meal delivery to cafe host; medical transportation to home chores; fitness monitor to activity leader!

Seniors With Anxiety Frequently Don’t Get Help. Here’s Why.

Anxiety is the most common psychological disorder affecting adults in the U.S. In older people, it’s associated with considerable distress, as well as ill health, diminished quality of life, and elevated rates of disability.

Yet, when the U.S. Preventive Services Task Force, an independent, influential panel of experts, suggested last year that adults be screened for anxiety, it left out one group—people 65 and older.

The major reason the task force cited in draft recommendations issued in September: “The current evidence is insufficient to assess the balance of benefits and harms of screening for anxiety” in all older adults. (Final recommendations are expected later this year.)

The task force noted that questionnaires used to screen for anxiety may be unreliable for older adults. Screening entails evaluating people who don’t have obvious symptoms of worrisome medical or psychological conditions.

“We recognize that many older adults experience mental health conditions like anxiety” and “we are calling urgently for more research,” said Lori Pbert, associate chief of the preventive and behavioral medicine division at the University of Massachusetts Chan Medical School and a former task force member who worked on the anxiety recommendations.

This “we don’t know enough yet” stance doesn’t sit well with some experts who study and treat seniors with anxiety. Dr. Carmen Andreescu, an associate professor of psychiatry at the University of Pittsburgh, called the task force’s position “baffling” because “it’s well established that anxiety isn’t uncommon in older adults and effective treatments exist.”

“I cannot think of any danger in identifying anxiety in older adults, especially because doing so has no harm and we can do things to reduce it,” said Dr. Helen Lavretsky, a psychology professor at UCLA.

In a recent editorial in JAMA Psychiatry, Andreescu and Lavretsky noted that only about one-third of seniors with generalized anxiety disorder—intense, persistent worry about everyday matters—receive treatment. That’s concerning, they said, considering evidence of links between anxiety and stroke, heart failure, coronary artery disease, autoimmune illness, and neurodegenerative disorders like dementia. Other forms of anxiety commonly undetected and untreated in older adults include phobias (like a fear of dogs), obsessive-compulsive disorder, panic disorder, social anxiety disorder (a fear of being assessed and judged by others), and post-traumatic stress disorder.

The smoldering disagreement over screening calls attention to the significance of anxiety in later life—

a concern heightened during the COVID-19 pandemic, which magnified stress and worry among seniors. Here’s what you should know.

Anxiety is common. According to a book chapter published in 2020, authored by Andreescu and a colleague, up to 15% of people 65 and older who live outside nursing homes or other facilities have a diagnosable anxiety condition.

As many as half have symptoms of anxiety—irritability, worry, restlessness, decreased concentration, sleep changes, fatigue, avoidant behaviors—that can be distressing but don’t justify a diagnosis, the study noted.

Most seniors with anxiety have struggled with this condition since earlier in life, but the way it manifests may change over time. Specifically, older adults tend to be more anxious about issues, such as illness, the loss of family and friends, retirement, and cognitive declines, experts said. Only a small fraction develop anxiety after turning 65.

Anxiety can be difficult to identify in older adults. Older adults often minimize symptoms of anxiety, thinking “this is what getting older is like” rather than “this is a problem that I should do something about,” Andreescu said.

Also, older adults are more likely than younger adults to report “somatic” complaints—physical symptoms, such as dizziness, fatigue, headaches, chest pain, shortness of breath, and gastrointestinal problems—that can be difficult to distinguish from underlying medical

conditions, according to Gretchen Brenes, a professor of gerontology and geriatric medicine at Wake Forest University School of Medicine.

Some types of anxiety or anxious behaviors—notably, hoarding and fear of falling—are much more common in older adults, but questionnaires meant to identify anxiety don’t typically ask about those issues, said Dr. Jordan Karp, chair of psychiatry at the University of Arizona College of Medicine in Tucson.

When older adults voice concerns, medical providers too often dismiss them as normal, given the challenges of aging, said Dr. Eric Lenze, head of psychiatry at Washington University School of Medicine in St. Louis and the third author of the recent JAMA Psychiatry editorial.

Simple questions can help identify whether an older adult needs to be evaluated for anxiety, he and other experts suggested: Do you have recurrent worries that are hard to control? Are you having trouble sleeping? Have you been feeling more irritable, stressed, or nervous? Are you having trouble with concentration or thinking? Are you avoiding things you normally like to do because you’re wrapped up in your worries?

Stephen Snyder, 67, who lives in Zelienople, Pennsylvania, and was diagnosed with generalized anxiety disorder in March 2019, would answer “yes” to many of these queries. “I’m a Type A personality and I worry a lot about a lot of things—my family, my finances, the future,” he said. “Also, I’ve tended to dwell on things that happened in the past and get all worked up.”

Treatments are effective. Psychotherapy—particularly cognitive behavioral therapy, which helps people address persistent negative thoughts— is generally considered the first line of anxiety treatment in older adults. In an evidence review for the task force, researchers noted that this type of therapy helps reduce anxiety in seniors seen in primary care settings.

Also recommended, Lenze noted, is relaxation therapy, which can involve deep breathing exercises, massage or music therapy, yoga, and progressive muscle relaxation.

Because mental health practitioners, especially those who specialize in seniors’ mental health, are extremely difficult to find, primary care physicians often recommend medications to ease anxiety. Two categories of drugs—antidepressants known as SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors)—are typically prescribed, and both appear to help to older adults, experts said.

Whether

So we do everything we can to make you feel at home whenever you’re on our campus, from comfortable furniture on our iconic front porch, to seeing your favorite foods on the menu, to staff members who feel like friends and treat you like family. Call 740.362.9641

Frequently prescribed to older adults, but to be avoided by them, are benzodiazepines, a class of sedating medications, such as Valium, Ativan, Xanax, and Klonopin. The American Geriatrics Society has warned medical providers not to use these in older adults, except when other therapies have failed, because they are addictive and significantly increase the risk of hip fractures, falls and other accidents, and short-term cognitive impairments.

Source: KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—the independent source for health policy research, polling, and journalism. Read more at kffhealthnews.org.

you’re at Ohio Living Sarah Moore for assisted living, long-term nursing care, or short-term rehabilitation, one thing remains the same we don’t believe that you’re living in our facility. We believe that we’re working in your home.

Caprese Stuffed Portobellas

This recipe makes four servings.

3 tablespoons extra-virgin olive oil, divided

1 medium clove garlic, minced

½ teaspoon salt, divided

½ teaspoon ground pepper, divided

4 large portobella

mushrooms, stems and gills removed OR 8 smaller mushrooms

1 cup halved cherry or grape tomatoes

½ cup fresh mozzarella pearls, drained and patted dry

½ cup thinly sliced fresh basil

Balsamic reduction

1. Preheat oven to 350 degrees F.

2. To prepare portobella mushroom caps, gently twist off the stems of whole portobellas.

3. Using a spoon, scrape off the brown gills from the underside of the mushroom caps.

4. Give them a quick rinse, then pat dry.

5. Combine 2 tablespoons oil, garlic, 1/4 teaspoon salt, and 1/4 teaspoon pepper in a small bowl.

6. Using a brush, coat mushrooms all over with the oil mixture.

7. Place on a large rimmed baking sheet and bake until the mushrooms are mostly soft, about 10 minutes.

8. Meanwhile, stir tomatoes, mozzarella, basil, and the remaining 1/4 teaspoon salt, 1/4 teaspoon pepper, and 1 tablespoon oil together in a medium bowl.

9. Once the mushrooms have softened, remove from the oven and fill with the tomato mixture.

10. Bake until the cheese is fully melted and the tomatoes have wilted, about 12 to 15 minutes more.

11. Drizzle each mushroom with balsamic reduction.

Notes: Feel free to add Italian sausage or pesto chicken to this dish to add meat. Suggested sides to serve: Italian pasta salad, Caesar salad, or fresh roasted veggies.

Cauliflower Chickpea Curry

This recipe makes four servings.

2 cups of cauliflower florets

1 cup of chickpeas/garbanzo beans

½ cup of diced white onions

2 teaspoons grated garlic

2 teaspoons grated ginger

½ cup canned diced tomatoes

1 tablespoon oil

1 tablespoon + 1 teaspoon curry powder (more if you like a stronger flavor)

1 teaspoon cinnamon

1 teaspoon cumin

24 ounces coconut milk, unsweetened

1. Thaw cauliflower, if using frozen cauliflower. If using fresh cauliflower, wash and cut into florets.

2. Drain garbanzo beans.

3. Medium-small dice the onions.

4. Grate the ginger and garlic.

5. Drain the canned tomatoes.

6. Saute the onions in oil.

7. When onions are translucent, add in garlic and ginger and continue sauteing, about 1 minute.

8. Add in curry powder, cinnamon, cumin, salt, and diced tomatoes and stir until combined, with the onion mixture.

9. Stir in coconut milk, turn heat to high, and bring to a boil. As soon as the curry begins to boil, return the heat to low, allow to simmer for 5 minutes, stirring often.

10. Using an immersion blender, blend the base of the curry until smooth .

11. Turn the heat to high again and bring the curry back to a boil, then add the cauliflower and chickpeas.

12. Turn the heat to low and simmer until cauliflower is tender.

Notes: Serve over plain or cilantro rice. If you would like to add meat to this recipe, chicken would be a great option! If you’d like more veggies, add carrots and/or peas to the recipe, or serve on the side.

Enjoy these nutritious meals and more at SourcePoint!

Cafe 55 is open Monday through Friday from 11 a.m. to 1:30 p.m.

For Delaware County residents 55+, lunch is available on a donation basis. (Suggested donation of $5.) Those under 55 may purchase lunch for $8.

An Update from Your County Prosecutor

It continues to be an honor and a blessing to serve as your Delaware County Prosecutor!

We are officially half-way through 2023, and time never seems to slow down does it? The prosecutor’s office continues to be the busiest it has been in the last several years. I thought I’d take this opportunity to update you on a few major criminal cases that we wrapped up over the past year, and to tell you about a new scam circulating the county.

2022 was certainly a year of accountability in the office. If you recall, an active shooter opened fire on I-71 in Delaware County in March of 2022. First, he shot multiple rounds at southbound traffic narrowly missing passengers in two different vans and a multitude of other travelers on the roadway. Then, the shooter turned his fire on law enforcement, who arrived on the scene and ran towards his gunfire to protect the travelers on I-71. Ultimately, our heroes who wear the shield were able to apprehend the shooter, and we prosecuted him in Delaware County. Just nine months later, the shooter was sentenced to 25-31.5 years in prison after he pled guilty to multiple counts of attempted murder and attempted aggravated murder. Fast forward to March of 2023, I recognized as “Top Cops” the heroic officers from the Columbus Police Department who protected everyone on I-71 that day. We are lucky as citizens to have so many dedicated law enforcement who remain willing to protect us in today’s climate.

The summer of 2022 also brought the horrific trial of Laylah Bordeau. She was accused of driving under the influence of fentanyl and killing an entire family from Powell when she drove across the middle barrier of I-71 and into oncoming traffic. Ultimately, the jury found her guilty of multiple counts of aggravated vehicular homicide and sentenced her to the maximum sentence of 32-36 years in prison.

In the fall of 2022, our special victim prosecutor, Cory Goe, successfully prosecuted Muata Fisher for sexually abusing a child. A jury found Fisher guilty of multiple sexual assault charges including rape of a minor and gross sexual imposition. Fisher is now serving five life sentences for his crimes.

Just a few months ago we wrapped up a homicide trial involving a case where the body of a man was found in a plastic tote by

a kayaker on Alum Creek. The investigation was led by the Delaware County Sheriff’s Office and ultimately the evidence led detectives to suspect Timothy Baldrick. After executing a search warrant, detectives found a video of the homicide with Baldrick as the shooter. Baldrick was found guilty of aggravated homicide by a Delaware County jury, and he was sentenced to life in prison with parole eligibility after 36 years.

These cases are just a small sample of the tireless work our criminal assistant prosecutors do every day to protect and serve our community. In 2022, nearly 600 indictments were filed for various felony crimes—with low-level drug possession being the most frequent charge filed.

One final note to make you aware of—there is an ongoing scam purported to be related to the criminal justice system in Delaware County. A criminal will contact an unsuspecting resident and tell the resident that there is active arrest warrant for his or her arrest, and the criminal will even use the names of elected officials like the Delaware County Sheriff or Common Pleas Judge Gormley or Judge Schuck to make the scheme seem more believable. The criminal will then tell the resident that if the resident pays a fee, the arrest warrant can be lifted. Unfortunately, some residents fall victim to this scam and pay the criminal, only to find out later it was a fraud.

Stay vigilant—no one from the criminal justice field will demand you pay money to lift an arrest warrant. That is not how it works in our profession. If you do get contacted, please call your local law enforcement agency so that we can continue to investigate these criminals and bring them to justice in a court of law for defrauding our citizens.

Melissa A. Schiffel is the Delaware County Prosecuting Attorney. Learn more at prosecutor.co.delaware.oh.us or call 740-833-2690.

Can You Lengthen Your Life?

Researchers explore how to stay healthy longer

Want the secret to living a longer and healthier life? Scientists have found ways to prolong the healthy lifespans of worms, mice, and even monkeys. Their work has revealed exciting new clues about the biology of aging. But solid evidence still shows that the best way to boost the chance of living a long and active life is to follow the advice you likely heard from your parents: eat well, exercise regularly, get plenty of sleep, and stay away from bad habits.

People born in the U.S. today can expect to live to an average age of 79. A century ago, life expectancy was closer to 54. “We’ve had a significant increase in lifespan over the last century,” says Dr. Marie Bernard, deputy director of NIH’s National Institute on Aging. “Now if you make it to 65, the likelihood that you’ll make it to 85 is very high. And if you make it to 85, the likelihood that you’ll make it to 92 is very high. So people are living longer, and it’s happening across the globe.”

Older people tend to be healthier nowadays, too. Research has shown that healthful behaviors can help you stay active and healthy into your 60s, 70s, and beyond. In fact, a long-term study of Seventh-day Adventists—a religious group with a generally healthy lifestyle—shows that they tend to remain healthier into old age. Their life expectancy is nearly 10 years longer on average than most Americans. The Adventists’ age-enhancing behaviors include regular exercise, a vegetarian diet, avoiding tobacco and alcohol, and maintaining a healthy weight.

“If I had to rank behaviors in terms of priority, I’d say that exercise is the most important thing associated with living

longer and healthier,” says Dr. Luigi Ferrucci, an NIH geriatrician who oversees research on aging and health. “Exercise is especially important for lengthening active life expectancy, which is life without disease and without physical and mental disability.”

Natural changes to the body as we age can lead to a gradual loss of muscle, reduced energy, and achy joints. These changes may make it tempting to move less and sit more. But doing that can raise your risk for disease, disability, and even death. It’s important to work with a doctor to find the types of physical activity that can help you maintain your health and mobility. Even frail older adults can benefit from regular physical activity. One NIH-funded study included over 600 adults, ages 70 to 89, who were at risk for disability. They were randomly placed in either a moderate exercise program or a comparison group without structured exercise. The exercise group gradually

worked up to 150 minutes of weekly activity. This included brisk walking, strength and balance training, and flexibility exercises.

“After more than two years, the physical activity group had less disability, and if they became disabled, they were disabled for a shorter time than those in the comparison group,” Bernard explains. “The combination of different types of exercise—aerobic, strength and balance training, and flexibility—is important to healthy aging.”

Another sure way to improve your chances for a longer, healthier life is to shed excess weight. “Being obese—with a body mass index (BMI) higher than 30—is a risk factor for early death, and it shortens your active life expectancy,” Ferrucci says. BMI is an estimate of your body fat based on your weight and height. Talk with a doctor about reaching a healthy weight.

Studies in animals have found that certain types of dietary changes—such as extremely low-calorie diets—can lead to longer, healthier lives. These studies offer clues to the biological processes that affect healthy aging. But to date, calorierestricted diets and other dietary changes have had mixed results in extending the healthy lives of people.

“We have indirect evidence that nutritional adjustments can improve active longevity in people, but this is still an area of intense research,” Ferrucci says. “So far, we don’t really have solid evidence about caloric restriction and whether it may have a positive effect on human aging.” Researchers are now studying

potential drugs or other approaches that might mimic calorie restriction’s benefits. Not smoking is another pathway to a longer, healthier life. “There’s no question that smoking is a hard habit to break. But data suggests that from the moment you stop smoking, there are health benefits. So it’s worthwhile making that effort,” Bernard says.

You might think you need good genes to live longer. But genes are only part of the equation for most, says Dr. Thomas Perls, an aging expert and director of the New England Centenarian Study at the Boston University School of Medicine. “Research shows genes account for less than onethird of your chances of surviving to 85. The vast majority of variation in how old we live to be is due to our health behaviors,” Perls says. “Our genes could get most of us close to the remarkable age of 90 if we lead a healthy lifestyle.”

The influence of genes is stronger, though, for people who live to older ages, such as beyond 95. Perls has been studying people who live to age 100 and up and their families to learn more about the biological, psychological, and social factors that promote healthy aging.

“It seems there’s not a single gene that imparts a strong effect on the ability to get to these older ages,” Perls says. “Instead, it’s the combined effects of probably hundreds of genes, each with weak effects individually, but having the right combination can lead to a very strong effect, especially for living to the oldest ages we study.”

It’s a good idea to be skeptical of claims for a quick fix to aging-related problems. Perls cautions against marketed “anti-aging” measures like“hormone replacement therapy,” which has little proven benefit for healthy aging and can have severe side

effects. “People used to say, ‘the older you get, the sicker you get.’ But with common sense, healthy habits like regular exercise, a healthy weight, avoiding red meat, not smoking, and managing stress, it can be ‘the older you get, the healthier you’ve been,’” Perls says.

The key to healthy aging is to engage fully in life—mentally, physically, and socially. “Transitioning to older years isn’t about sitting in a rocking chair and letting the days slip by,” Bernard says. “Older adults have unique experiences, intellectual capital, and emotional involvement that can be shared with younger generations. This engagement is really key to helping our society move forward.”

Source: NIH News in Health, a monthly newsletter from the National Institutes of Health, part of the U.S. Department of Health and Human Services. Read more at newsinhealth.nih.gov.

Wise Choices: Stay Healthy at 50+

Get moving. Exercise can reduce the risk for age-related diseases and disability.

Eat a healthy diet. Get tips at ChooseMyPlate.gov.

Saturday

Marion Palace Theatre

Special guest Michael Delfin

Beethoven 7th Sym.

Night Songs

Timpani Concerto

The Holiday performance of the Summer!

Pay attention to weight and shape. Extra weight, especially at the waist or with muscle loss, can raise health risks. Talk to your doctor about weight concerns.

Don’t smoke or use tobacco.

Keep your brain active. Get tips for a healthy brain.

Be good to yourself. Get enough sleep. Stay in touch with family and friends. And surround yourself with people you enjoy.

Get regular medical checkups.

Drink only in moderation if you drink alcohol.

Stress and How to Reduce It

Recently, 66-year-old Cliff moved to a new community and was having trouble finding affordable housing. His temporary solution—an extended-stay hotel—cost more than his $736 monthly Social Security check could cover. Most days, that meant he didn’t eat.

Linda, 62, faced a different set of challenges. Right before COVID-19 hit, she lost both her job and her marriage. Newly unemployed and living alone, she wasn’t sure how to navigate these uncharted waters by herself.

And Charlsie, 83, struggles to understand technology. Already “somewhat of a worrier,” her mistrust of any call on her phone has unwittingly isolated her from relatives and friends whose help with paperwork and other tasks could be a relief.

None of these older adults know each other, but they each share something in common: Stress.

What is stress?

According to the World Health Organization, stress is a mental reaction to challenging circumstances. Cliff’s financial instability. Linda’s layoff and divorce. Charlsie’s technophobia and isolation.

From an evolutionary standpoint, stress exists to help humans survive; it’s the basis of what scientists commonly call the “fightor-flight” response. We experience it both emotionally and physically; yet the signs of stress can sometimes be easy to miss.

Why? Because the condition is so prevalent in everyday American life. As Cliff explained, “I didn’t even realize how much the stress of not having money to pay for housing was affecting me.”

That’s precisely why it’s so important to look for red flags. While some stress actually can be helpful, chronic stress can lead to negative health outcomes that worsen with age.

“Stress is a fact of life that most of us experience at one time or another,” said Jennifer Tripken, associate director of NCOA’s Center for Healthy Aging. “But the unique relationship between stress and aging means that older adults and their families, friends, and caregivers should pay particular attention to what causes it, how to recognize it, and what to do about it.”

Let’s take a closer look.

Does stress affect older adults more?

In a word, yes.

According to the American Institute of Stress, stress and inflammation are closely linked. Further, stress negatively impacts the body’s ability to effectively respond to certain kinds of inflammation that lead to age-related conditions.

In other words, more stress equals more inflammation, and more inflammation when we’re stressed equals more (or worse) health problems. These include atherosclerosis (hardening of the arteries), Type 2 diabetes, arthritis, dementia, and cancer, to name a few. The same report notes that chronic stress also can reduce the effectiveness of certain vaccines in older adults, including for the flu and pneumonia. And stress actually accelerates the aging process itself.

You can see that stress and age don’t play well together,” Tripken said. “Learning how to manage it is so important to maintaining long-term health and well-being.”

What causes stress?

Just as the effects of stress can vary in different age groups, so can the reasons we experience it. A younger person might feel stressed out due to launching a new career, starting a family, or paying off student loan debt, for instance. An older adult likely has a different set of worries.

Some common causes of stress in older adults include:

• Chronic illness.

• Caregiving responsibilities.

• Loss and grief.

• Loneliness or boredom.

• Financial worries.

• Major life changes, such as retirement.

What are the symptoms of stress?

Because of its relationship to inflammation and disease, learning to recognize the emotional and physical signs of stress can be an important first step toward taking care of your health. In an older person, these can include: Headaches, digestive issues, irritability, heart palpitations, sleep disturbances, poor concentration, crying, and social withdrawal.

This list isn’t exhaustive, Tripken explained, and individuals may exhibit many of these signs or just one. Plus, it’s easy to make excuses for stress, or—like Cliff—fail even to recognize it. But if something feels off, it probably is. If your moods or daily habits have changed, this can be a clue that you’re experiencing stress.

Top 6 ways to deal with stress

The good news is, there are some really good stress management strategies anyone can use. Even better, you don’t have to try them all, or all of them at once. Choose one or two approaches that interest you and are realistic.

1. Remove the source. This isn’t always possible, but if you can, try to identify what’s causing your stress and do something to change that. Cliff, for example, got help paying for housing. Linda asked about applying for SNAP benefits. And Charlsie took steps to overcome her technophobia by seeking assistance at her local community center.

2. Eat well. Following a healthy, balanced diet can boost the immune system, help combat the effects of inflammation, and fuel positive physical energy. And, filling up on bulky, good-foryou fruits and vegetables can prevent “stress-eating” a bag of potato chips or pint of ice cream.

Sudoku

3. Stay hydrated. Drinking enough water yields many health benefits, including improved brain performance. Adding a glass or two a day can help keep you mentally sharp and stabilize your emotions.

4. Exercise. Regular physical activity helps reduce blood pressure, ease arthritis pain, combat chronic illness, and lift your mood. And you don’t have lace up a pair of running shoes and start training for a marathon to reap these benefits, either. Even gentle movement like tai chi can make a world of difference.

5. Get enough sleep. Sleep is essential to good physical and mental health. It’s the time when the body repairs itself and the mind takes a break. Establishing “sleep-friendly” routines can help to reduce stress-related insomnia and other negative effects.

6. Meditate. Engaging in deep breathing, positive visualization, and other mindfulness practices can help calm racing thoughts, slow a rapid heart rate, relax tensed-up muscles, and create a sense of well-being.

Remember: everyone experiences stress from time to time. Being proactive about managing yours can maintain your physical and mental health and well-being so you can age well.

Source: National Council on Aging. Read more at ncoa.org.

See Sudoku Solutions on page 29.

Facts on Falls

Falls are, unfortunately, a common occurrence.

Falls are a serious health issue among seniors. While falls in the general population usually come about due to dangerous work or leisure activities, older adults are at greater risk of falling in their day-to-day activities. Medications, vision impairments, and general weakness can combine with environmental factors to put older adults in danger of seriously injuring themselves in any fall.

population. This leads to substantial costs both to the families of fall victims and to society at large.

The average cost for treating a fall is $30,000.

More than 300,000 people are hospitalized each year from broken hips, and 95% of these fractures are the result of a fall, according to the Centers for Disease Control.

Falls are the leading cause of fatal injury among older adults, and the most frequent reason for non-fatal trauma.

According to Medical Alert Advice, 1 in 3 adults has trouble getting into and out of the bathtub.

Many factors contribute to falls. A person’s health is a significant factor in predisposing them to falls, along with other related factors like medications and recent surgery. Environmental challenges related to the loss of strength and balance as people age also make falls more likely, and some demographic factors contribute. The top contributing factors to fall risk are, in order: age, being female, a history of previous falls, and a fear of falling.

Living alone may also be a risk factor in falls, and 2 million senior Americans may be shut-ins.

Every 11 seconds, an older adult is treated in the emergency room for a fall.

According to the National Council on Aging, one in four Americans over 65 falls each year.

Falls take a psychological toll, as well: up to 50% of those who fear falling limit or exclude social or physical activities because of this fear.

Falls in adults aged 65+ are the leading cause of head injuries and broken hips, with 1 in 10 falls resulting in serious injuries, such as hip fracture, other fractures, subdural hematoma, or traumatic brain injury.

Adults lose 10% in strength and endurance for every decade after the age of 30. Combined with a similar loss in muscle power (30% per decade), this leads to a decrease in physical function among seniors that puts them at greater fall risk.

Almost a quarter of 65+ adults characterized themselves as having ambulatory disabilities. e.g., difficulty walking or climbing stairs.

In 2014, older Americans experienced 29 million falls, resulting in 7 million injuries.

Every 19 minutes, an older adult dies from a fall.

Falls can cause serious injuries, and present a rising cost to society. Outcomes of falls range from the minor cuts and bruises that anyone could expect to the worst possible results—disability and death. Overall, unfortunately, because of pre-existing health issues, lower bone and muscle strength, and other factors, falls among the elderly tend to have worse outcomes than among the general

Falls are the most common cause of traumatic brain injuries for people in every stage of life, and result in 800,000 total hospitalizations in America each year. Falls result in more than 2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths.

A full 80% of falls happen in the bathroom, according to National Institute on Aging.

In the elderly living in the community, 30 to 50% of falls are due to environmental causes, e.g., poor lighting, slippery floors, and uneven surfaces.

Benzodiazepines in older people is associated with a 44% increase in risk of hip fracture and night falls.

Types of drugs that contribute to falls include sedatives and antidepressants, and, to a lesser extent, drugs for lowering blood pressure.

Vascular diseases, chronic obstructive pulmonary disease, depression, and arthritis are each associated with a 32% increased risk of falls among the elderly Fortunately, there are ways to reduce the risks of falling.

Source: Aging.com.

Actively Reducing the Chances of a Fall

There are many fall protection systems marketed through private companies and public websites. Many of these programs use similar strategies, and as you work to reduce the risk of falling, you should take advantage of these common approaches.

Address any medical conditions – Seek frequent medical checkups. Your health is the most important aspect of fall protection.

Modify the environment – To reduce the risk of a fall, reduce the number of hazards in your home. And as you do so, keep in mind your or your loved one’s physical limitations so you can eliminate particular risks. Some common modifications include front-door showers, putting carpet on floors, widening door frames, reducing door curb height, and installing various fall protection systems.

Improve your physical fitness – Beginning a daily exercise regimen greatly reduces the risk of a fall. Benefits include stronger muscles, bones, and connective tissue, an increased awareness of the environment, more energy for greater balance and a stronger gait, and a higher resistance to unexpected events. Special exercises may be employed to bolster weaker areas and improve holistic physical fitness.

Get the right clothes and shoes – Any and all loose clothing that could catch on a door frame, nail, or furniture should be removed from the home. Choose shoes that fit and avoid shoes that are too slick, high heels, flip flops, and stockings.

Improve your home’s lighting – Your home should be neither too bright nor too dark. A dark home hides hazards, and a home that is too bright can be just as dangerous. If there is so much light

that it causes the resident of the home a problem, then it should be reduced. This includes rooms in the home that may let in too much sunlight during peak hours.

Incorporate appropriate assist devices –Older adults who have physical limitations may need to use a walker or cane to help them get around, and you should adjust your fall prevention plan accordingly. In addition, many fall prevention programs include installing grab bars throughout the home.

Get proper nutrition – Eating properly helps an older adult engage more thoroughly with the surrounding environment. A good diet improves the nervous system, gives energy to the body’s muscle systems, and encourages heightened brain function. Getting adequate liquids can produce similar benefits.

Source: Aging.com.

SourcePoint created Falls-Free Zone to provide comprehensive information to help prevent falls. Join us this summer at the Delaware County District Library Main Branch in Delaware for free interactive sessions!

Register at MySourcePoint.org/EC or call 740-363-6677.

Thursday, July 13, 1‒2 p.m.

Learn how to identify and address hazards in the home that increase the risk of falling to keep you safe in your own home for as long as possible.

Thursday, July 27, 1‒2 p.m.

Learn how to maintain safety in the community and the importance of planning in advance to decrease the risk of falls outside of the home.

Interested in bringing the Falls-Free Zone series to your organization or group? Contact Allison Chakroff at 740-363-6677.

How to Grow Your Social Network as You Age

Friends sitting around a table, talking and laughing. A touch on the arm, as one of them leans over to make a confiding comment. A round of hugs before walking out the door.

For years, Carole Leskin, 78, enjoyed this close camaraderie with five women in Moorestown, New Jersey, a group that took classes together, gathered for lunch several times a week, celebrated holidays with one another, and socialized frequently at their local synagogue.

Leskin was different from the other women— unmarried, living alone, several years younger—but they welcomed her warmly, and she basked in the feeling of belonging. Although she met people easily, Leskin had always been something of a loner and her intense involvement with this group was something new.

Then, just before the COVID-19 pandemic struck, it was over. Within two years, Marlene died of cancer. Lena had a fatal heart attack. Elaine succumbed to injuries after a car accident. Margie died of sepsis after an infection. Ruth passed away after an illness.

Leskin was on her own again, without anyone to commiserate or share her worries with as pandemic restrictions went into effect and waves of fear swept through her community. “The loss, the isolation; it was horrible,” she said.

What can older adults who have lost their closest friends and family members do as they contemplate the future without them? If, as research has found, good relationships are essential to health and well-being in later life, what happens when connections forged over the years end?

It would be foolish to suggest these relationships can easily be replaced: They can’t. There’s no substitute for people who’ve known you a long time, who understand you deeply, who’ve been there for you reliably in times of need, and who give you a sense of being anchored in the world.

Still, opportunities to create bonds with other people exist, and “it’s never too late to develop meaningful relationships,” said Robert Waldinger, a professor of psychiatry at Harvard Medical School and director of the Harvard Study of Adult Development.

That study, now in its 85th year, has shown that people with strong connections to family, friends, and their communities are “happier, physically healthier, and live longer than people who are less well connected,” according to “The Good Life: Lessons From the World’s Longest Scientific Study of Happiness,” a book describing its findings, co-written by Waldinger and Marc Schulz, the Harvard study’s associate director.

Waldinger’s message of hope involves recognizing that relationships aren’t only about emotional closeness, though that’s important. They’re also a source of social support, practical help, valuable information, and ongoing engagement with the world around us. And all these benefits remain possible, even when cherished family and friends pass on.

Say you’ve joined a gym and you enjoy the back-and-forth chatter among people you’ve met there. “That can be nourishing and stimulating,” Waldinger said. Or, say, a woman from your neighborhood has volunteered to give you rides to the doctor. “Maybe you don’t know each other well or confide in each other, but that person is providing practical help you really need,” he said. Even casual contacts—the person you chat with in the coffee shop or a cashier you see regularly at the local supermarket— “can give us a significant hit of well-being,” Waldinger said. Sometimes, the friend of a friend is the person who points you to an important resource in your community you wouldn’t otherwise know about.

After losing her group of friends, Leskin suffered several health setbacks—a mild stroke, heart failure, and, recently, a nonmalignant brain tumor—that left her unable to leave the house most of the time. About 4.2 million people 70 and older are similarly “homebound”—a figure that has risen dramatically in recent years, according to a study released in December 2021.

Determined to escape what she called “solitary confinement,”

Leskin devoted time to writing a blog about aging and reaching out to readers who got in touch. She joined a virtual travel site and found a community of people with common interests, including five (two in Australia, one in Ecuador, one in Amsterdam and one in New York) who’ve become treasured friends.

740-363-6677 |

“Between Facebook Messenger and email, we write like oldfashioned pen pals, talking about the places we’ve visited,” she told me. “It has been lifesaving.”

Still, Leskin can’t call on these long-distance virtual friends to come over if she needs help, to share a meal, or to provide the warmth of a physical presence. “I miss that terribly,” she said.

Research confirms that virtual connections yield mixed results. On one hand, older adults who routinely connect with other people via cell phones and computers are less likely to be socially isolated than those who don’t, several studies suggest. Shifting activities for older adults, such as exercise classes, social hours, and writing groups online, has helped many people remain engaged while staying safe during the pandemic, noted Kasley Killam, executive director of Social Health Labs, an organization focused on reducing loneliness and fostering social connections. But when face-to-face contact with other people diminishes significantly—or disappears altogether, as was true for millions of older adults in the past three years—seniors are more likely to be lonely and depressed, other studies have found.

“If you’re in the same physical location as a friend or family member, you don’t have to be talking all the time: You can just sit together and feel comfortable. These low-pressure social interactions can mean a lot to older adults and that can’t be replicated in a virtual environment,” said Ashwin Kotwal, an assistant professor of medicine in the division of geriatrics at the University of California-San Francisco who has studied the effects of engaging with people virtually.

Meanwhile, millions of seniors—disproportionately those who are low-income, represent racial and ethnic minorities, or are older than 80—can’t afford computers or broadband access or aren’t comfortable using anything but the phone to reach out to others.

Liz Blunt, 76, of Arlington, Texas, is among them. She hasn’t recovered from her husband’s death in September 2021 from non-

Hodgkin lymphoma, a blood cancer. Several years earlier, Blunt’s closest friend, Janet, died suddenly on a cruise to Southeast Asia, and two other close friends, Vicky and Susan, moved to other parts of the country.

“I have no one,” said Blunt, who doesn’t have a cell phone and admitted to being “technologically unsavvy.”

In March, Blunt had seen only one person she knows fairly well in the past 4½ months. Because she has several serious health issues, she has been extremely cautious about catching COVID and hardly goes out. “I’m not sure where to turn to make friends,” she said. “I’m not going to go somewhere and take my mask off.”

But Blunt hadn’t given up altogether. In 2016, she’d started a local group for “elder orphans,” people without spouses or children to depend on. Though it sputtered out during the pandemic, Blunt thought she might reconnect with some of those people, and she sent out an email inviting them to lunch.

On March 25, eight women met outside at a restaurant and talked for 2 ½ hours. “They want to get together again,” Blunt said, with a note of eagerness in her voice. “Looking in the mirror, I can see the relief in my face. There are people who care about me and are concerned about me. We’re all in the same situation of being alone at this stage of life—and we can help each other.”

Source: KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—the independent source for health policy research, polling, and journalism. Read more at kffhealthnews.org.

Remote Work: An Underestimated Benefit for Family Caregivers

For Aida Beltré, working remotely during the pandemic came as a relief.

She was taking care of her father, now 86, who has been in and out of hospitals and rehabs after a worsening series of strokes in recent years.

Working from home for a rental property company, she could handle it. In fact, like most family caregivers during the early days of COVID-19, she had to handle it. Community programs for the elderly had shut down.

Even when Beltré switched to a hybrid work role—meaning some days in the office, others at home—caring for her father was manageable, though never easy.

Then she was ordered back to the office full time in 2022. By then, Medicaid was covering 17 hours of home care a week, up from five. But that was not close to enough. Beltré, now 61, was always rushing, always worrying. There was no way she could leave her father alone so long. She quit. “I needed to see my dad,” she said.

In theory, the national debate about remote or hybrid work is one great big teachable moment about the demands on the 53 million Americans taking care of an older or disabled relative.

But the “return to office” debate has centered on commuting, convenience, and child care. That fourth C, caregiving, is seldom mentioned.

That’s a missed opportunity, caregivers and their advocates say.

Employers and co-workers understand the need to take time off to care for a baby. But there’s a lot less understanding about

time to care for anyone else. “We need to destigmatize it and create a culture where it’s normalized, like birth or adoption,” said Karen Kavanaugh, chief of strategic initiatives at the Rosalynn Carter Institute for Caregivers. For all the talk of cradle to grave, she said, “mostly, it’s cradle.”

After her stepmother died, Beltré moved her father into her home in Fort Myers, Florida, in 2016. His needs have multiplied, and she’s been juggling. She’s exhausted and, now, unemployed.

She’s also not alone. About one-fifth of U.S. workers are caregivers, and nearly a third have quit a job because of their caregiving responsibilities, according to a report from the Rosalynn Carter Institute. Others cut back their hours. The Rand Corp. has estimated that caregivers lose half a trillion dollars in family income each year—an amount that’s almost certainly gone up since the report was released nearly a decade ago.

Beltré briefly had a remote job but left it. The position required sales pitches to people struggling with elder care, which she found uncomfortable. She rarely gets out—only to the grocery store and church, and even then she’s constantly checking on her dad.

“This is the story of my life,” she said. Workplace flexibility, however desirable, is no substitute for a national long-term care policy, a viable long-term care insurance market, or paid family leave, none of which are on Washington’s radar.

President Joe Biden gave caregivers a shoutout in his State of the Union address in February and followed up in April with an executive order aimed at supporting caregivers and incorporating their needs in planning federal programs, including Medicare and Medicaid. Last year, his Department of Health and Human Services released a National Strategy to Support Family Caregivers outlining how federal agencies can help and offering road maps for the private sector.

Although Biden checked off priorities and potential innovations, he didn’t offer any money. That would have to come from Congress. And Congress right now is locked in a battle over cutting spending, not increasing it.

So that leaves it up to families.

Remote work can’t fill all the caregiving gaps, particularly when the patient has advanced disease or dementia and needs intense round-the-clock care from a relative who is also trying to do a full-time job from the kitchen table.

But there are countless scenarios in which the option to work remotely is an enormous help.

When a disease flares up. When someone is recuperating from an injury, an operation, or a rough round of chemo. When a paid caregiver is off, or sick, or AWOL. When another family caregiver, the person who usually does the heavy lifting literally or metaphorically, needs respite.

“Being able to respond to time-sensitive needs for my dad at the end of his life, and to be present with my stepmother, who was the 24/7 caregiver, was an incredible blessing,” said Gretchen Alkema, a wellknown expert in aging policy who now runs a consulting firm and was able to work from her dad’s home as needed. That flexibility is what Rose Garcia has come to appreciate, as a small-business owner and a caregiver for her husband.

Garcia’s husband and business partner, Alex Sajkovic, has Lou Gehrig’s disease. Because of his escalating needs and the damage the pandemic wrought on their San Francisco stone and porcelain design company, she downsized and redesigned the business. They cashed in his retirement fund to hire part-time caregivers. She goes to work in person sometimes, particularly to meet architects and clients, which she enjoys. The rest of the time she works from home.

As it happened, two of her employees also had caregiving obligations. Her experience, she said, made her open to doing things differently.

For one employee, a hybrid work schedule didn’t work out. She had many demands on her, plus her own serious illness, and couldn’t make her schedule mesh with Garcia’s. For the other staff member, who has a young child and an older mother, hybrid work let her keep the job.

A third comes in full time, Garcia said. Since he’s often alone, his dogs come too. In Lincoln, Nebraska, Sarah Rasby was running the yoga studio she co-owned, teaching classes, and taking care of her young children. Then, at 35, her twin sister, Erin Lewis, had a sudden cardiac event that triggered an irreversible and ultimately fatal brain injury. For three heartbreaking years, her sister’s needs were intense, even when she was in a rehab center or nursing home. Rasby, their mother, and other family members spent hour after hour at her side.

Rasby, who also took on all the legal tasks for her twin, sold the studio.

“I’m still playing catch-up from all those years of not having income,” said Rasby, now working on a graduate degree in family caregiving.

Economic stress is not unusual. Caregivers are disproportionately women. If caregivers quit or go part time, they lose pay, benefits, Social Security, and retirement savings.

“It’s really important to keep someone attached to the labor market,” the Rosalynn Carter Institute’s Kavanaugh said. Caregivers “prefer to keep working. Their financial security is diminished when they don’t—and they may lose health insurance and other benefits.”

But given the high cost of home care, the sparse insurance coverage for it, and the persistent workforce shortages in home health and adult day programs, caregivers often feel they have no choice but to leave their jobs.

At the same time, though, more employers, facing a competitive labor market, are realizing that flexibility regarding remote or hybrid work helps attract and retain workers. Big consultant companies like BCG offer advice on “the working caregiver.”

Successful remote work during the pandemic has undercut bosses’ abilities to claim, “You can’t do your job like that,” observed Rita Choula, director of caregiving for the AARP Public Policy Institute. It’s been more common in recent years for employers to offer policies that help workers with child care. Choula wants to see them expanded “so that they represent a broad range of caregiving that occurs across life.”

Yet, even with COVID’s reframing of in-person work, telecommuting

is still not the norm. A March report from the Bureau of Labor Statistics found only 1 in 4 private businesses had some or all of their workforce remote last summer—a dropoff from 40% in 2021, the second pandemic summer. Only about 1 in 10 workplaces are fully remote.

And remote and hybrid work is mostly for people whose jobs are largely computerbased. A restaurant server can’t refill a coffee cup via Zoom. An assembly line worker can’t weld a car part from her father-in-law’s bedside.

But even in the service and manufacturing sectors, willing employers can explore creative solutions, like modified shift schedules or job shares, said Kavanaugh, who is running pilot programs with businesses in Michigan. Cross-training so workers can fill in for one another is another strategy.

New approaches can’t come soon enough for Aida Beltré, who finds joy in caregiving along with the burden. She’s looking for work, hybrid this time. “I am a people person,” she said. “I need to get out.”

She also needs to be in. “Every night, he says, ‘Thank you for all you do,’” she said of her father. “I tell him, ‘I do this because I love you.’”

Source: KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF— the independent source for health policy research, polling, and journalism. Read more at kffhealthnews.org.

Sudoku Solutions

Hot Weather Safety for Older Adults

Too much heat is not safe for anyone. It is even riskier if you are older or have health problems. It is important to be cautious and get relief quickly when you are overheated. Otherwise, you might start to feel sick or risk a heat-related illness that could cause serious health issues.

Why can extreme weather be more dangerous for older adults than for younger people? Hotter days can cause difficulty in the body’s ability to regulate its temperature. This can be challenging for older adults who typically do not adjust as well as others to sudden temperature changes. Additionally, older adults are more likely to have chronic medical conditions that affect the body’s response to temperature, and to take prescription medicines that alter the body’s ability to control temperature or sweat.

HEAT-RELATED ILLNESSES

Being overheated for too long or being exposed without protection to the sun can cause many health problems. Heatrelated illnesses include the following:

Heat syncope is a sudden dizziness that can happen when you are active in hot weather. If you take a heart medication called a beta blocker or are not acclimated to hot weather, you are even more likely to feel faint. Rest in a cool place, put your legs up, and drink water to make the dizzy feeling go away.

Heat cramps are the painful tightening or spasms of muscles in your stomach, arms, or legs. Cramps can result from hard work or intense exercise. Though your body temperature and pulse usually stay normal during heat cramps, your skin may feel moist and cool. Stop the physical activity you’re doing and rest in the shade or in a cool building. Drink plenty of fluids, such as water and sports drinks containing electrolytes. Do not consume alcohol or caffeinated beverages.

Heat edema is a swelling in your ankles and feet when you get hot. Put your legs up to help reduce swelling. If that doesn’t work fairly quickly, check with your doctor.

Heat rash is a skin irritation from heavy sweating. It causes red clusters of small blisters that look similar to pimples on the skin. Your skin may feel itchy or you may feel “prickly” tingling pain. Keep the infected area dry, use powder to sooth the rash, and stay in cool areas.

Heat exhaustion is a warning that your body can no longer keep itself cool. You might feel thirsty, dizzy, weak, uncoordinated, and nauseated. You may sweat a lot. Your body temp may stay normal, but your skin may feel cold and clammy. Some people

with heat exhaustion have a rapid pulse. Rest in a cool place and get plenty of fluids. If you don’t feel better soon, get medical care. Be cautious because heat exhaustion can progress to heat stroke.

Heat stroke is a medical emergency in which the body’s temperature rises above 104°F. Signs of heat stroke are fainting; confusion or acting strangely; not sweating even when it’s hot; dry, flushed skin; strong, rapid pulse; or a slow, weak pulse. When a person has any of these symptoms, they should seek medical help and immediately move to a cooler place, such as under shade or indoors. They should also take action to lower their body temp with cool clothes, a cool bath or shower, and fans.

Sun exposure, also known as sunburn, is a sign of skin damage due to extreme or long exposure. Your skin may appear red and tender, develop blisters, start to peel, and be warm to the touch. Severe reactions may cause fever, chills, nausea, or rash. Prevent sunburn by wearing protective clothing that covers your skin and staying out of direct sunlight. Using a broad spectrum sunscreen with an SPF of 15 or higher can also help prevent sunburns, but be sure to reapply often. If you are sunburned, wear lightweight clothing, take cool showers, moisturize affected areas, and stay out of the sun so your skin can heal.

If you are concerned about any of these heat-related illnesses, talk with your doctor.

WHAT RAISES THE RISK OF HEAT-RELATED ILLNESSES FOR OLDER ADULTS?

Older adults are at higher risk for heat-related illnesses and death. Factors that put older adults at greater risk may include:

• Problems like cardiovascular, lung, or kidney disease.

• Changes in skin caused by normal aging.

• Any illness that causes weakness or results in a fever.

• Taking drugs, such as diuretics, sedatives, tranquilizers, and some heart and high blood pressure medicines, that may make it harder for the body to cool itself.

• Being on several prescription drugs at the same time.

• Being obese, overweight, or underweight.

• Drinking alcoholic beverages.

• Living in places without air conditioning or fans.

• Becoming dehydrated.

TIPS TO STAY SAFE IN HOT WEATHER

Drink plenty of liquids, such as water, fruit or vegetable juices, or drinks that contain electrolytes. Avoid alcohol and caffeinated beverages. If your doctor has told you to limit your liquids, ask what you should do when it is very hot.

If you live in a home without air conditioning or fans, try to keep your space as cool as possible. Limit use of the oven; keep shades, blinds, or curtains closed during the hottest part of the day; and open windows at night.

If your living space is hot, try to spend time during midday in a place that has air conditioning. For example, go to the shopping mall, movies, library, senior center, or a friend’s home. You may also contact your local health department or city to find out if they have air-conditioned shelters in your area.

If you need help getting to a cooler place, ask a friend or relative. Some religious groups, senior centers, and Area Agencies on Aging provide this service. You could also consider taking a taxi or other car service or calling your local government to see if they offer senior transportation. Don’t stand outside in the heat waiting for a bus.

Dress for the weather. Wear lightweight, light-colored, loosefitting clothing. Natural fabrics, such as cotton, may feel cooler than synthetic fibers.

Avoid outdoor exercising and other physical activity when it is very hot. Instead, try to find someplace you can be active while staying cool indoors.

If you must go outside, try to limit your time out and avoid crowded places. Plan trips during non-rush-hour times.

Make sure to use a broad spectrum sunscreen, SPF 15 or higher, and reapply it throughout the day, especially if your skin will have continuous exposure to the sun. Wear a hat and other protective clothing, and sunglasses. If you do get sunburned, stay out of the sun until your skin is healed and use cool cloths and moisturizers to treat the affected area.

Ask your doctor if any of your medications make you more likely to become overheated or sunburned.

KEYS TO REMEMBER ABOUT HOT WEATHER SAFETY

Older people can have a tougher time dealing with heat and humidity. The temperature inside or outside does not have to be high to put them at risk for a heat-related illness.

Headache, confusion, dizziness, or nausea could be a sign of a heat-related illness. Go to the doctor or to an emergency room to find out if you need treatment.

To keep heat-related illnesses from becoming a dangerous heat stroke, remember to:

• Get out of the sun and into a cool, ideally air-conditioned place.

• Drink fluids but avoid alcohol and caffeine.

• Shower, bathe, or sponge off with cool water.

• Lie down and rest.

Source: National Institute on Aging Read more at nia.nih.gov.

Staying Safe in Hot Weather

SourcePoint’s 2023 Fundraiser

THURSDAY, SEPT. 14

Doors open at 5:30 p.m. for happy hour. Main event begins at 6:30 p.m.

MUSIC & DANCING

Featuring popular songs spanning four decades. Professional dancers will perform throughout the evening and you can join them on the dance floor!

FOOD & DRINK

Heavy hors d’oeuvres and two drink tickets included, plus cash bar.

LIVE AUCTION & ACTIVITIES

Opportunities to bid on fabulous items, plus other fun activities!

COSTUMES ENCOURAGED

Pull out your poodle skirt, dust off the tie dye and bell bottoms, or dig out the leg warmers!

Net proceeds benefit programs and services that help Delaware County adults thrive after 55.

Sponsored by