Navigating life today to remain independent tomorrow
COVER STORY oughts From Daddy's Girl ... pg. 48
Embracing the Sunset: A Sunny View of Retirement... pg. 9
How to Have a Happy Gut...pg. 19
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Over age 50, single, and ready to mingle? Let’s talk about it. There may be several reasons that you’re considering or already swimming in the dating pool. There’s divorce or death of your spouse/life partner. Or you’ve never married or never been in a committed relationship. I acknowledge polyamory as well, but don’t have the space here to address every iteration of romance. Instead, I’ll focus on what singles have in common. No matter your situation, if you’re over 50 and back “on the market” after many years, dating looks different now than it did 30 or more years ago.
Not only is dating different, you are also different. Those two things alone can make the prospect of dating both daunting and exciting. While that’s not much different than when you were younger, now you have the advantage of life experience, rich emotional depth, and improved critical thinking. At least, that’s my hope for you. Armed with that wealth, I’d suggest that to date successfully you must first determine what exactly it is that you want.
From casual sex to a committed relationship, you owe it to yourself to consider what qualities you want in a partner and which behaviors are red flags. Stick to your must-haves and your deal-breakers. One of the luxuries of dating after 50 is that there is less societal pressure to couple up. You’re mature enough to recognize that any pressure is simply someone else’s projection of their fears and desires onto you. Their problem, not yours. You’ve reached the age of knowing what’s best for you. That includes when and with whom you have sex. Conducting all communication with clarity, tact, and kindness is never out of style. Tolerate no less in return.
Before all that, how do you even begin to date after 50? There are certainly dating apps. But if technology doesn’t appeal to you, the old-fashioned ways still work. Sign up for groups that match your hobbies and interests. Attend local events. Tell close friends and family you’re interested in dating again. They know you best and are likely to recognize a good match for you.
I realize these few paragraphs don’t delve into the complexities of our need for companionship and human touch, the emotional and financial stakes after a long relationship no matter how it ended or being newly single and in poor health. In this edition of Compass & Clock you can read ‘Dating Over 50’ by Gary Floring.
If you don’t want to date, I see you. I want to help you fully enjoy your life. Whatever that entails, as always, you’ll find guidance in this issue on:
• Healthcare • Housing Choices • Legal Guidance • Financial Planning
Leisure Pursuits
Family Support
Visit our website at www.compassandclock.com to choose how you receive the future planning information we offer: subscribe to our YouTube channel, podcast, and newsletter, or sign up for home delivery.
Mary Coupland Publisher/Editor-in-Chief Founder, Owner, and CEO, Compass & Clock
Member of NAIPC WA Chapter (National Aging in Place Council)
Member of Kitsap Provider Group
Member of the Sequim-Dungeness Valley Chamber of Commerce
Past Board Member Peninsula Services
Past President, Board of Directors, Mavericks Bainbridge
Past Board Member, Bainbridge HS Baseball Boosters
206-627-0790
compassandclockmc@gmail.com www.compassandclock.com
Tony Hinson
Consultant/Advisor
Attorney and Principal of Sherrard McGonagle Tizzano & Lind, P.S.
With over 27 years of legal experience, Tony focuses on estate planning, estate & gi taxation, elder law, & complex probate matters. Admitted to Practice in Washington, North Carolina, and Texas (Inactive)
Washington State Bar Association APEX Award Winner – 2016
2021 Best of Kitsap Award Winner
Member – Kitsap County Bar Association
Board Member and Treasurer – Kitsap Humane Society
Past Board Member – North Kitsap Fishline, Kitsap Legal Services, and West Sound Academy
Retired US Navy JAG – 25 Years Total Service
Presenter – 2020 65th Annual Estate Planning Seminar Sponsored by University of Washington and the Estate Planning Council of Seattle
Presenter – 2019 and 2020 Kitsap Estate Planners Seminar Sponsored by Kitsap Community Foundation and Olympic College
We are a group of compassionate, experienced, dedicated professionals. Our goal is to provide you with all the current news and resources you need to stay on top of your game for middle age, retirement and well into your senior years.
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Proud
5This Should Concern You!
7Financially Planning For Retirement
9Embracing the Sunset: A sunny view of retirement
11Open the Door to a Reverse Mortgage HEALTH CARE
12The Connection Between Hearing Loss and Dementia
14We Are What We Consume: Food and Drug Interactions
16Minimize Your Risk: Exercises & Strategies to Prevent Falling
18Fall Prevention & Detection
19How To Have A Happy Gut
20Shingles: Symptoms & Treatment Options
22Telemedicine: Top-Quality Care Wherever You Are
24The Importance of Early Detection in Alzheimer’s Disease
27Why Do People Fall?
28What’s That Ringing In My Ears? HOUSING OPTIONS
30It’s Time to Winterize Your Home!
31The Good and the Bad of Living /Retiring Abroad LEGAL GUIDANCE
33 Authentically Planning Your Golden Years
34What is Business Law?
36Anatomy Of A Personal Injury Claim LEISURE PURSUITS
38Dating After 50
40The Best Looks For Fall Fashions!
41Will a DNA Test Provide Answers to Your Questions?
43Fighting Food Insecurity
46 Pet Ownership Today FAMILY SUPPORT
48Thoughts From Daddy’s Girl
50 Remembering Vivian
52Technology & AI Will Help You Age in Place
54RESOURCE DIRECTORY
By Mike Adams
So much talk about the United States government debt of $30 trillion. That is a problem. But even more is worldwide debt of $307 trillion. The US debt stands at 123% of US GDP. The $307 worldwide debt stands at 300 percent of worldwide GDP!
Six of the G-7 nations now have government debt greater than 100 percent of GDP. Those countries:
• Japan (255%)
• Italy (144%)
• United States (123%)
• France (110%)
• Canada (106%)
• UK (104%)
There are 54 nations that are on the verge of a financial crisis. Twenty-two of those nations have either already defaulted on their debt or are on the razor’s edge of default.
There are only five ways out of excessive debt and the world has excessive debt.
1
The world can grow their economies faster and pay down the debt.
2
3
4
4 45 5
The world nations can raise taxes holding spending constant and use the higher taxes to pay down debt.
Reduce spending on education, infrastructure and the social net and use the savings to pay down debt. That means cutting social security, healthcare, unemployment benefits, food stamps, agricultural subsidies and more.
Increase inflation so there is more currency to pay down the debt owed.
Default on interest payments and reduce or delete principal payments.
Three point three billion people live in countries facing the risk of defaulting on their sovereign debt. African nations are paying interest rates that are four times the rates paid in the United States and as much as eight times the rates paid in some of the wealthiest Euro Zone countries.
Think back to the 2007-2008 financial crisis. In the United States it began with subprime homeowners defaulting on their debt. Subprime mortgages had been packaged together into CDOs (collateralized debt obligations as were prime mortgages. Those CDOs were actively traded from bank to bank and to ensure payment some firms developed CDS (credit default swaps). As long as the economy was doing well the trading of those CDOs was creating high profits for Wall Street and the banking sector.
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When the music stopped, when the economy slowed, the subprime CDO prices dropped, wiping out profits. Banks and institutions began to dump the CDOs and exercise credit default swaps. The panic in subprime CDOs spread to the prime CDO mortgages. The viability of banks and Wall Street firms to survive dived. Credit dried up even for borrowers that had solid collateral and reputations. The economy slowed even further.
Bear Stearns collapsed. Even three months after that the Fed along with other central banks was claiming there was little risk of a recession. That changed in the second half of 2008. It was as if the Fed suddenly discovered the risk was not just a recession. It was then that Ben Bernanke told congress that there was a crisis heading toward calamity. Vice President Cheney said it was “Herbert Hoover time.” Senator Mel Martinez serving on the Senate Banking Committee said the crisis was going to be “Armageddon.”
The response was rapid. The Federal Reserve, US Treasury, and central banks all around the world pumped trillions of dollars into their economies. It was not just the developed world printing money. The emerging countries borrowed to keep their economies going.
It worked. The world economies recovered, and worldwide GDP grew at a pace above average. The recovery launched a supercycle. Central banks began to offload the debt they
had taken on to combat the Great Recession.
Then the pandemic hit. Once again, the central banks stepped in by printing money and emerging countries added a boat load of additional debt to keep their economies growing.
Today there is little alarm raised about the very high level of debt. The last time US debt was this high was at the end of World War II when debt reached 104 percent of GDP. Today it is 123 percent of GDP and economists are guessing the risk of recession is reduced and a “soft landing” is becoming more probable.
The Fed, like many central banks around the world, seems almost blind to the worldwide debt. Those same institutions were oblivious of the pending failure of the housing market collapse that brought about the Great Recession. Maybe the supercycle will lift world GDP to levels to pay off the debt. But that is highly optimistic.
What will be the impact of the world debt on investments in your portfolio? The old Boy Scout motto was “Be Prepared.” Are you?
Mike Adams, President & Principal, Adams Financial Concepts LLC, 206.903.1019, https://adamsfinancialconcepts. com/.
By Mary Coupland
As life expectancy increases, retirees face the challenge of ensuring their savings last throughout their retirement years. Proper planning, including estimating longevity and managing withdrawals from retirement accounts, can mitigate the risk of running out of money.
The pandemic prompted many people to reassess their financial situations and retirement plans. Some individuals may have started saving more or adjusting their investment strategies in response to economic uncertainty.
What did you do? Did you make any changes or are you just hoping for the best?
My entire adult life I have always fully participated in the savings programs that my employers offered as part of our benefits package at the workplace. Each paycheck I would have the maximum amount of taxes deducted and I would contribute to my 401K retirement plan faithfully. Over the years as my retirement nest egg slowly grew, my husband suggested I convert my 401K into a Roth IRA, and he has
helped me manage, trade, and grow my account.
The Roth IRA move was a smart move, and here’s why. A Roth IRA is an Individual Retirement Account to which you contribute after-tax dollars. While there are no currentyear tax benefits, your contributions and earnings can grow tax-free, and you can withdraw them tax-free and penalty free after age 59½ and once the account has been open for five years.
But, while having a Roth IRA is highly beneficial, I didn’t feel that continuing to manage it ourselves would provide the financial growth needed for a sustainable retirement.
So, I did something. Two years ago, I reached out to a financial advisor I knew and trusted. I asked questions. He asked me what my goals were. Together we outlined an aggressive ten-year plan, which we wouldn’t have been able to formulate and execute if my husband and I continued to manage the funds ourselves.
Planning for retirement involves several key considerations to ensure financial security and peace of mind. I want to share with you some do’s and don’ts, along with insights into common challenges and considerations to help you
attain your proper financial future:
Do's for Financial Retirement Planning:
Start Early: Begin saving and investing for retirement as early as possible to take advantage of compounding returns. If you haven’t started saving yet, it’s never too late to start saving.
Set Clear Goals: Determine your retirement goals and estimate the income needed to maintain your desired lifestyle.
Diversify Investments: Spread your investments across different asset classes (stocks, bonds, real estate) to reduce risk.
Maximize Retirement Accounts: Contribute regularly to retirement accounts like 401(k)s, IRAs, or similar plans to benefit from tax advantages.
Budget and Track Expenses: Understand your current expenses and create a budget to manage spending during retirement.
Consider Healthcare Costs: Plan for potential healthcare expenses, including insurance premiums, deductibles, and long-term care.
Don’ts for Financial Retirement Planning:
Underestimate Inflation: Account for inflation when calculating how much you’ll need in retirement.
Rely Solely on Social Security: Supplement Social Security with other savings to ensure an adequate income stream.
Neglect Emergency Savings: Maintain a separate emergency fund for unexpected expenses to avoid dipping into retirement savings.
Ignore Estate Planning: Create or update your estate plan, including wills and powers of attorney, to protect your assets and ensure your wishes are carried out.
Take on Too Much Debt: Minimize debt before retirement to reduce financial stress and improve cash flow.
Don’t forget to consider major expenses that can occur during retirement such as:
Healthcare: Including insurance, medications, and potential long-term care.
Housing: Mortgage payments, property taxes, maintenance, and utilities.
Travel and Leisure: Enjoying hobbies, traveling, and entertainment.
Family Support: Assisting children or elderly parents financially.
A good roadmap for retirement planning includes goal setting; saving and investing regularly and wisely; monitoring and reviewing your plan periodically and adjusting as needed; and seeking professional advice with a financial advisor or planner to optimize your retirement strategy.
Beware and avoid pitfalls that can get in the way of your retirement dreams. Don’t procrastinate and delay saving for retirement, as it can significantly impact your financial security. Be realistic about your investment returns and adjust your expectations. And ignoring risks is a big nono. Consider risks such as inflation, healthcare costs, and market volatility in your planning, you’ll be glad you did.
Taking a moment to consider the do's and don’ts; having a road map with realistic expectations; and staying informed about financial trends and changes, can better prepare you for a financially secure retirement.
By Ted Butler
Have you ever dreamt of living in a tropical paradise? Does the idea of trading the cold and damp of winter for the sun and sand of the Mexican riviera sound appealing? Do you think it’s out of reach?
Well, let me introduce you to David, with whom I had the pleasure of having dinner with on my trip to Mexico earlier this year. David spends five months of the year in a picturesque condo overlooking the charming seaside town of Puerto Vallarta, Mexico. A sprightly septuagenarian with a sharp mind and a heart full of cherished memories, David embodies the spirit of embracing life’s adventures even in one’s golden years. David’s life story is one of resilience, love, and financial wisdom. He spent over four decades in the insurance industry, where he honed his skills in numbers and money management. His career provided him with a comfortable lifestyle and a deep understanding of financial instruments. However, life threw a curveball when his beloved wife passed away eight years ago. The loss was profound, but David found solace in the memories they created together, particularly their annual vacations to Puerto Vallarta.
I first met David at one of my seminars. He was notable not only because of the copious notes he was taking, but also because of the probing questions he was asking, it
was evident that this was an individual to whom numbers and money had meaning.
To realize his dream, David turned to a powerful financial tool: the modern reverse mortgage. This decision was rooted in his deep understanding of finances and his desire to maximize his home equity without compromising his lifestyle. And while David did not use a HECM on his condominium in Mexico, he did place one on his home back home in the Pacific Northwest. HUD designed this program to help keep older homeowners in their own home, freeing them of the obligation to make a monthly mortgage payment and provide access to some of the wealth home appreciation creates for American homeowners.
A reverse mortgage allows homeowners aged 62 and older to convert a portion of their home equity into cash. Unlike a traditional mortgage, there are no monthly mortgage payments. And, as with any mortgage, all the borrower remains responsible for is property tax, homeowner’s insurance, and any HOA fees. Instead of monthly payments, the loan is repaid when the homeowner sells the house, moves out permanently, or passes away. David saw this as an opportunity to access the value locked in his home without selling it. Allowing him to keep his home base in the states while at the same time enjoy his special time in Mexico.
David’s first step was to assess his financial situation.
With a keen eye for detail, he evaluated his home equity, his living expenses, and the costs associated with living part-time in Puerto Vallarta. He consulted with a financial advisor to ensure that a reverse mortgage was the right choice for him. Confident in his decision, David proceeded with the application process.
Once approved, David received the funds from his reverse mortgage and began planning his annual escape to Puerto Vallarta. He found a cozy condo with a breathtaking view of the Pacific Ocean. The condo’s balcony became his favorite spot, where he could sip his morning coffee while watching the sun rise and set over the town.
Living in Puerto Vallarta for five months each year has brought a renewed sense of purpose and joy to David’s life. The town’s vibrant atmosphere, friendly locals, and stunning natural beauty provide a perfect backdrop for his adventures. He spends his days exploring the local markets, enjoying fresh seafood, and taking long walks along the beach with Bootsy.
David has also formed a close-knit community of friends in Puerto Vallarta. The expatriate community is welcoming and diverse, offering opportunities for socializing and shared experiences. David participates in local events, cultural festivals, and volunteer activities, making the most
of his time in this tropical paradise.
One of the most significant benefits of the reverse mortgage for David is the financial peace of mind it provides. With the additional funds, he can comfortably cover his living expenses in both his home country and Mexico. He doesn’t have to worry about monthly mortgage payments, allowing him to focus on enjoying his retirement to the fullest.
David’s expertise in the insurance industry has made him particularly adept at managing his finances. He maintains a detailed budget, ensuring that his expenditures align with his income. The reverse mortgage serves as a financial cushion, enabling him to manage unexpected expenses without stress.
Bootsy, David’s faithful feline companion, plays a significant role in his life. The bond between them has only grown stronger since his wife’s passing. Bootsy adapts well to the seasonal changes, enjoying the warmth of Puerto Vallarta and the cozy comforts of their home during the rest of the year. The condo’s spacious balcony is Bootsy’s favorite spot, where he lounges in the sun and watches the bustling town below.
As David reflects on his journey, he often thinks of his wife and the life they shared. The decision to use a reverse mortgage to spend part of the year in Puerto Vallarta is, in many ways, a tribute to her memory. Each day spent in their beloved vacation spot is a reminder of the beautiful moments they enjoyed together.
David’s story is a testament to the power of financial wisdom and the importance of living life to the fullest. By leveraging his home equity through a reverse mortgage, he has created a lifestyle that brings him joy, adventure, and peace. His experience highlights the potential of modern financial tools to enhance the quality of life for retirees, allowing them to pursue their dreams and create lasting memories.
David’s journey with a reverse mortgage is a compelling example of how financial acumen and a love for life can lead to fulfilling and enriching experiences. With Bootsy by his side and the stunning backdrop of Puerto Vallarta, David continues to embrace each day with enthusiasm and gratitude. His story inspires others to consider the possibilities that a reverse mortgage can offer, proving that it’s never too late to chase your dreams and create new memories.
Ted Butler, Lifestyle Home Loan Specialist, Mutual of Omaha, NMLS #71436 Serving WA, CA, AZ, ID and OR. Phone: 425-889-8989 / Cell: 425-891-6644, 11900 NE 1st St. Ste 300, Bellevue WA. 98005 | https://mutualreverse.com/ lo/ted-butler/
1. The modern reverse mortgage is a Federal Mortgage program, created by HUD. It was signed into law in 1988 as the FHA Home Equity Conversion Mortgage or HECM.
2. It was created by HUD to replace old bank created Reverse Mortgages with the emphasis on safety, security and transparency for the senior homeowner to provide a way for them to continue to age in place by allowing them safe access to some of their housing wealth without the need for monthly repayment.
3. It is a mortgage, the lender will charge interest for the use of their money, but different than with a conventional mortgage, there is no monthly mortgage payment. And as with any other mortgage the borrower remains responsible for property tax, homeowner’s insurance and any HOA fees.
4. The most common misconception is that somehow the bank or the government get the home….This is not correct. The homeowner retains title along with full rights and responsibilities of home ownership. The same as any other mortgage.
5. Rights of home ownership include the ability to sell the home at any point; to pay off the loan at any point without prepayment penalty; and when the last borrower passes, the home transfers to the homeowner’s estate and they will have the option to keep the home by paying off the outstanding balance, or, as is most common, sell the home, pay off the balance and then the estate or heirs receive the remaining equity.
6. This is an FHA mortgage and carries a very special kind of FHA Mortgage Insurance making this loan non-recourse, meaning that if the home value were to drop below the amount owed, this insurance will cover that shortfall for the borrower, or their heirs and the lender. You cannot pass on a debt to your heirs.
7. It is an age-restricted program. The minimum age for the FHA HECM is 62. The minimum age of a spouse is 18. The maximum age is 150. The program can only be used on one’s primary residence which can be a Single-Family Residence, an FHA Approved condominium, Duplex, Triplex, Fourplex and manufactured homes built after June 1976, on owned land.
8. The amount a borrower can qualify for is based on a calculation using the age of the youngest borrower, the appraised value of the home and the expected rate. The older the borrower the more HUD allows access to.
9. If the last homeowner is in the home when they pass, the house will transfer to their estate. The estate must notify the loan servicer within 30 days of passing what their intent is, to keep the home or sell the property. If the estate is going to sell the home, which is the most common, HUD will provide the estate 6 months to settle, and can provide up to two additional 3-month extensions with a proper written request.
10. The FHA HECM can be used to purchase a home as well as to be used as a refinance on an existing home. For a purchase, the down payment amount is based on the same HUD calculation using the age of the youngest borrower, the purchase price of the home and the expected rate. The HECM will cover that part, the borrower will bring the balance as the down payment and have no monthly mortgage payment. Like a cash purchase, no monthly payments, and like a conventional purchase, not requiring all of a borrower’s cash.
11. When might the FHA HECM be a fit? Looking to eliminate your largest monthly expense, your mortgage payment? Need funds for home improvement? Funds for in home care, or to pay off credit cards, or… just to live your best life!
Mikhail Nilov
By Bonnie Dickson
A2023 Johns Hopkins study found that adults with greater severity of hearing loss were more likely to have dementia. The study also found that people with hearing aids had a lower chance of dementia compared to non-users. A Denmark cohort study echoes these results in research that published this year that included 573,088 people. People with hearing loss in that study experienced a 7 percent higher risk of dementia than those without hearing loss. More significantly, the study also linked the use of hearing aids with prevention, delay, or progression of dementia. It wasn’t the first time that researchers were indicating a possible link but the size of the study and an objective for the study to investigate the relationship between dementia and hearing loss and the use of hearing aids. The Denmark study concluded that compared with people without hearing loss, people with hearing loss had a higher risk for dementia and the people who used hearing aids decreased their risk of dementia.
“Hearing loss is a critical public health issue affecting twothirds of Americans over the age of 70,” according to the Johns Hopkins study. That study found that the prevalence of dementia among study participants with moderate to severe hearing loss was 61 percent higher than among participants with normal hearing. While hearing aids did not bring the field level again, using them was associated with a 32 percent lower prevalence of dementia.
A Hopkins Bloomberg article on Aging in America notes that 6.9 million Americans live with Dementia and by 2060 that number is expected to explode to 13.8 million. While we have yet to understand why hearing loss increases the risk for dementia, there are at least some guesses.
One of those is that people with hearing loss experience a higher level of isolation. Isolation’s effect on mortality has been likened to smoking fifteen cigarettes a day. Hearing loss can affect opportunities to spend time with other people, make it harder to maintain relationships with others and create a spiral that eventually gets out of control when people experience mental health issues and find it even harder to maintain relationships.
The benefit of being able to tie hearing aids with positive results for holding off dementia is that a small number of people who should be wearing hearing aids do so, between 10 to 20 percent. Being able to point to that link may cause people to seek treatment.
Another suggestion is that people with hearing loss add to their cognitive load by trying to understand and decode words and sounds that there is no remaining capacity to process the actual meaning of messages. This added strain may contribute to an increased risk of dementia.
There are additional studies that suggest that hearing loss changes your brain structure.
While more studies are needed because researchers aren’t able to say now whether you can reverse memory loss by getting hearing aids, there are some suggestions
that taking care of suspected hearing loss now improves the chances of being able to get used to hearing aids and improving your quality of life.
Tips to help you communicate with someone who is experiencing hearing loss:
Limit background noise. Turn off or down other sources of noise or go somewhere quieter. If you are going out, ask for a quieter location rather than one by the kitchen or restroom or near a large party.
Get their attention prior to starting a conversation. That doesn’t mean waving your arms around or making loud noises.
Keep your face and mouth uncovered and use good eye contact. Trying to communicate during Covid was difficult because most of our communications with people are not with our voice but with our facial features and bodily clues. Imagine if the voice you are hearing is distorted in addition to having it be muted because it is coming from another room or over someone’s shoulder. Don’t chew food or gum while talking and take off your sunglasses. Keep your hands away from your mouth. Choose locations with good lighting so facial expressions are discernible.
Speak naturally. Don’t shout or mumble, don’t change your speaking cadence. Don’t allow your sentence to trail off. Shouting actually distorts words. Don’t exaggerate. Use
intentional pauses to allow the person time to process your speech. When you change the subject make note of it, so it clearly starts a new line of thinking.
Rephrase misunderstood speech rather than repeating it. Try explaining the sentence by adding additional details. Ask what wasn’t understood so you don’t try to explain things they already understand.
Make use of technology. There are speech-to-text apps such as Dragon, Otter or LiveTranscribe, but also hearing aids that work with smartphones. Those devices often work differently depending on the environment you are in. Asking the person you are with where they want to sit or stand can allow them to find a location that works best with the device they are using.
Ask them what works for them. Be respectful. Don’t jump to conclusions about their ability to hear.
If you are the one with hearing loss, get help. Sometimes even everyday drugs like aspirin or antibiotics can damage your hearing. If you seek help, you may prevent permanent loss. Hearing aids have come a long way from the ear trumpet. Often it is virtually invisible and more importantly they are becoming more affordable. For mild to moderate hearing loss, you may even be able to use over-the-counter hearing aids. Just remember that hearing loss may be a symptom of some other health issue and people should still consult with a professional first.
About one-third of older adults have hearing loss, and the chance of developing it increases with age.
Trouble understanding people over the phone
Finding it hard to follow conversations when two or more people are talking
Often asking people to repeat themselves
Needing to turn up the TV volume higher than other people do
Trouble understanding others because of background noise
Thinking that others seem to mumble
By Dr. Sean A. Valdez, PharmD
It really is amazing what we put into our bodies without giving it a second thought. Whether it’s the food we eat, the air we breathe, the water we drink, it is not as pure as we’d like it to be, but we give it no second thought for the most part because we need it to live. Now consider all the other things that we take in, that in addition to those above, are necessary for living a healthier life. The medication we take, the supplements we add to it, the over-the-counter items we purchase to add to that. They all exact a measured toll, and we don’t know when, why or how we will come to pay it. No pun intended but I want this to be “food” for thought for you as an empowered patient. I want you to think for a moment about the myriad items that you might be taking and let yourself think about how they all interact or potentially interact with one another. To that end, I want you to think not only of those things you know of which interact by interfering with each other but with the things you may not have ever considered. That is why our
pharmacy team at Olympic Pharmacy exists and why so many in our profession do what they do to empower you as the patient to be armed with the knowledge you need to protect yourself and your family and friends from the things you may not have even considered.
It is no secret that everything we take or are prescribed is not always going to “play nice in the sandbox.” This is the inferred, inherent, and acceptable risk of “better living through chemistry.” For even the most innocuous of medications or supplements of foods can have unexpected deleterious effects. Let us take for example the simplest and often overlooked drug: Alcohol. Its known effect singularly claims 178,000 lives annually, making it one of the leading preventable causes of death in the US. This only tells a small part of the story. The leading cause of death globally according to the World Health Organization is ischemic heart disease. It claimed 9.1 million in 2021, representative of 13 percent of all-cause mortality worldwide. The largest part of this statistic is a lifestyle characterized by the use of alcohol and tobacco as key drivers to comorbidity.
Through my professional journey I have come across a great many patients who readily accepted the inherent risk of alcohol and tobacco use alone but they never connected the fact that both alcohol and tobacco can exacerbate other conditions they might be treating with prescribed medications, conditions that, ironically enough, were brought about by alcohol, tobacco and lifestyle. Furthermore, and most importantly, they had not yet considered alcohol’s and tobacco’s respective impacts on the patient’s medications as it pertains to metabolism (breakdown) of medications and their ensuing pharmacologic effect.
The powerhouse of all metabolism and drug breakdown starts with a healthy functioning liver. It is the key component in identifying successful outcomes as it pertains to drug therapy, especially for those medications metabolized in the liver. Drugs cleared through the liver have specific pathways and those pathways are integral pieces to the effectiveness of a drug as much as it is to the drug’s adverse effect profile or expected adverse effect profile. Consider a healthy liver. No problems in function or encumbered by disease. Most medications are quickly and easily metabolized, the adverse effects tend to be lesser in degree and the intended effect is generally clear, clean, and precise. Conversely, as years age this hepatic behemoth, fewer viable receptor sites are available for drug metabolism. Its processing ability slows down, hence the need for adjustment when the body ages. Add to it alcohol and a high fat diet as well as other hepatically cleared medications and you increase the risk for drug/ drug interactions, drug/food interactions and drug/alcohol interactions. You increase the intended effect of one drug, decrease the intended or desired effect of another or several and then other organ systems may begin to slow down or in some instances shut down completely.
Those are the direst of circumstances and yet are the most preventable. The best “medicine” for this is your pharmacist. We are always there to answer your questions and address your concerns, especially as it pertains to you, your health, and the health of loved ones. It is not always an easy battlefield to navigate but you needn’t do it alone, especially with newer medications and supplements becoming available to us every year. On average, the Food and Drug Administration approved thirty-eight new medications per year from 2010 to 2019. Additionally, over one thousand new dietary supplements are introduced annually. This does nothing but add to the confusion of the world of appropriate and safe pharmacotherapy. Furthermore, some foods we consume can impact a drug’s bioavailability and resultant effectiveness. For instance,
most patients I have counseled taking levothyroxine, a drug commonly prescribed for thyroid dysfunction and a disease that affects more than 12 percent of the US population currently, don’t realize that it must be the sole drug taken before any other food, drink or medication due to its best absorption effect on an empty stomach. Another drug class affected by food is the antibiotic drug class. Some need to be taken with a meal, some should not be. Tetracyclines, for example, are often chelated or bound by something as simple as milk. That is due to calcium in the dairy product.
There are so many medications out there intended for a healthier life but what we don’t know and don’t learn about them can literally kill us. Here at Olympic Pharmacy, we are here to help by educating you and your loved ones and by arming you with the most up to date knowledge to provide better outcomes for a safe and healthy life.
Olympic Pharmacy, 4700 Point Fosdick Dr # 120, Gig Harbor, (253) 858-9941, https://www.olympicpharmacy.com/
By Assistance Now and Dr. Christine Baranic
Everyone seems worried about falls.
Why are falls so important?
A third of adults over 65 years of age fall each year.
A quarter of those falls result in lacerations, hip fractures, or head traumas (such as subdural hematoma).
Over half of unintentional deaths from injury are due to falls in the 65 plus population.
Ninety-five percent of hip fractures are from a fall.
Twenty percent of people with hip fractures die of complications within a year.
I am nervous about falling. Do falls “just happen” as we get older? Most falls are preventable. While no one can predict who will or will not fall, knowing your risk factors can help identify areas of concern. The higher the number of risk factors you have, the greater your risk of falling. If you know your risk factors, then you can minimize them.
RISK FACTORS CHECKLIST
Physical Risks
• History of falls this year.
• Muscle weakness (unable to stand from a chair 5 times in 15 seconds without using your hands, or weak grip strength).
• Feeling nervous about falling.
• Difficulty walking (uneven or off-balance walking across a room).
• Dizziness when standing up (blood pressure drops more than 20 mmHg) or when turning your head.
• Slowed reflexes (loss of balance when slightly nudged).
• Poor vision (cataracts, glaucoma, macular degeneration, blurred vision), or difficulty tracking objects.
• Poor sensation (partial or complete loss of feeling in feet).
• Confusion (not oriented to self, time, and place) or
difficulty following simple instructions.
• Poor appetite.
• Multiple medications (taking four or more medications), taking medications with side effects of weakness or dizziness, or having interactions leading to dizziness, vertigo, particularly hypnotics or benzodiazepines.
• Poor footwear (loose slippers, unstable base of shoe, poor fitting shoes, or old worn shoes).
• Any of the following medical conditions: Parkinson’s disease, osteoporosis, dementia, atrial fibrillation, seizure disorders, arthritis or joint pain, vertigo, stroke, anemia, loss of limb(s), UTI, diabetes, and/or incontinence.
Home Risks
• Clutter on floor
• Loose rugs
• No railings at steps or stairs
• No grab bars in showers or near toilets
• High threshold bathtub
• Low toilet seats
• Poor lighting, particularly during nighttime toileting
• Poor arrangement of furniture (cluttered).
• Hard to reach objects, such as dishes or self-care items.
• Inadequate supervision
Behavioral Risks
• Impulsive movements (poor planning, not fully thinking about physical limitations before moving)
• Carrying items that are too heavy or awkward.
• Carrying items when a two-handed walker is needed.
• Using the wrong assisted device (for example, using a cane when a walker is more appropriate)
What are some easy things I can do right now to lower my risk?
• Visit your medical doctor regularly to know if there
have been any changes in your medical condition, particularly those affecting your strength, sensation, vision, and memory.
• See a physical therapist at least once a year to evaluate or identify:
• your fall risk factors.
• postural issues, or deficits with strength, range of motions, balance, etc., which may limit mobility to make sure you are still using the right assistive device to individualize your exercise program so you can get the most out of your exercise program (achieve your highest physical potential safely).
• check for home fall risks (see checklist above)
See which risk factors you can change to reduce your number of risks factors and see which ones you cannot. Keep in mind, the risk of inactivity is often greater than the risk of activity. There is a 10-20 percent reduction in strength for every week of bed rest. Be sure you have enough “reserve” so if you get sick, you do not become too weak.
What are some general exercises that I can start doing now?
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• First, be sure to check with your medical doctor and/ or physical therapist before beginning any exercise program to be sure you are doing the right exercises for YOU!
• Meet with a physical therapist, who can develop an individualized program, based on your specific conditions, abilities, and goals.
• Begin a structured exercise program for at least 20 minutes most days.
• For example, do your strengthening exercises 3 times per week, and if possible, walk for 15-30 minutes 3 times per week. It is okay to have a rest day, but do not have more than 2 days off in a row.
• If any exercises cause you to have pain, dizziness, chest pain or heaviness, severe shortness of breath, or other unusual symptoms, stop immediately. Feel free to modify any exercise (reduce the range of motion, number or repetitions, or the intensity of the exercise) as needed.
• Set a goal and keep track of your exercises! Goals will help motivate you to do your daily exercises.
Prepared by Assistance Now, 888-877-7562, www. assistancenow.com
The Mobli, is a safety smartwatch that monitors falls, safety and well-being. Loved ones can easily view vitals, daily activity, medications taken, location and easy push to talk with no need to fuss with buttons or software on the watch.
Age-related changes such as problems with balance and gait, worsening eye sight and slower reaction times account for 3 million emergency department visits each year due to falls in older adults. With Assistance Now, your loved one is always in the safe zone with a smartwatch that is not a stigma to wear, very simple to use, and covers all aspects of safety.
For when you can’t be there to protect the people you love from life’s accidents, it’s time to ‘get them to The Safe Zone!’
•Fall Prevention and Detection
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•Powerful 4G LTE Wireless Technology
•Powered by Samsung and AT&T
•Built and Monitored by Healthcare Professionals
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By Bonnie Dickson
oon after you are born, microbes begin to populate your colon. This microscopic world is distinctive to you. Trillions of organisms live there and affect each other and in turn you in a symbiotic relationship that exchanges food and shelter for breaking down complex carbohydrates and dietary fiber and turning them into short-chain fatty acids and some vitamins, including B1, B9, B12 and K.
Your gut microbiome, a distinct ecosystem characterized by its environment and its inhabitants includes over a thousand species of bacteria, fungi, viruses, and parasites. They help to clear out unhelpful, pathogenic types of microbes and represent about 80 percent of your body’s immune cells. An unhealthy microbiome makes for an unhealthy host. A list of diseases and disorders associated with an unhealthy gut include cancer, chronic inflammation, neurological, behavioral, nerve pain and mood disorders according to the Cleveland Clinic. Other conditions and disorders include diarrhea, small intestinal bacterial overgrowth, inflammatory bowel disease such as colitis and Crohn’s disease and contributes to cardiovascular risk (hardening of the arteries) but the list goes on and on.
You can tell there is something wrong with your gut microbiome because your stomach hurts and you may have diarrhea or constipation. A medical provider may use blood, stool, or breath tests to check for specific conditions such as infections or bacterial overgrowth. A gut imbalance is called dysbiosis. Dysbiosis is more common as we age. Menopause is also linked to loss of gut bacteria diversity. Some recent research appears to indicate that greater gut diversity may slow the aging process. In the study, older people with greater gut diversity had lower levels of bad cholesterol and higher levels of vitamin D.
Concentrate on eating a plant-based diet with adequate fiber. Only about 3 percent of Americans get the recommended 28 grams of fiber per day. Because our appetites decrease as we age, it may be necessary to double down on fiber by choosing the highest fiber foods. Those include raspberries, potatoes, lentils, and beans.
Get enough fluids. Yes, water, but also fruits and vegetables have elevated levels of water. You can also drink milk, coffee, juice, and tea.
Eat foods with live active cultures. Foods such as yogurt, kefir, kimchi, and sauerkraut provide beneficial bacteria. Eat at least one serving per day.
Stay active. Physical activity increases blood flow to the gut, helping to pass food faster.
Don’t smoke. The chemicals in cigarette smoke can upset the gut microbiome.
Eliminate or reduce alcohol consumption. Alcohol abuse is the most significant risk for a digestive disorder.
Regularly review your medications with your doctor or pharmacist. Medications, such as laxatives, proton pump inhibitors, antibiotics and more can kill not just bad bacteria but beneficial bacteria as well.
According to GI Alliance, 20 million Americans suffer from chronic digestive diseases. Digestive diseases represent one of the most serious health problems in the US in terms of discomfort and pain, personal expenditures for treatment, working hours lost, and mortality.
Medical treatments for gut microbiome include the elimination diet, antibiotics, fecal transplant, exercise, chemotherapy, or home remedies such as castor oil.
See a gastroenterologist right away if you:
• Have a noticeable change in bowel habits.
• See blood on or in the stool that is either bright or dark.
• Experience unusual or persistent abdominal/gas pains.
• Have a very narrow stool.
• Feel like the bowel has not completely emptied after passing stool.
• Experience unexplained weight loss.
• Have frequent or persistent nausea/vomiting.
• Experience constant fatigue.
• Have anemia.
Remember to discuss any diet or supplements with your doctor.
There isn’t enough science out there on elimination diets. If you haven’t tried other solutions, they are not the solution to start with.
By Mary Coupland
Shingles, also known as herpes zoster, is a viral infection caused by the varicella-zoster virus— the same virus that causes chickenpox. After a person recovers from chickenpox, the virus can remain dormant in the nerve tissues near the spinal cord and become reactivated later in life, causing shingles.
How common is shingles? About 1 million cases of shingles are diagnosed every year in the U.S. The risk of shingles increases as you get older, with about half the cases occurring in people over the age of 50. Shingles develops in about 10 percent of people who have had chickenpox at an earlier time in their lives.
Anyone who has had chickenpox can develop shingles. Most people get chickenpox during childhood, but the
virus remains dormant in the body and can reactivate decades later, especially when the immune system weakens due to factors like aging, stress, or illness. The bad news is that if you’re an adult who hasn’t had chickenpox, you’re at a higher risk of suffering severe complications if you do get it. Chickenpox is much more dangerous in adults than it is in children which is why it’s recommended that adults get the chickenpox vaccine if they’ve never had chickenpox.
If you have not had chickenpox before, you cannot get shingles directly because shingles is caused by the reactivation of the varicella-zoster virus, which lies dormant in individuals who have previously had chickenpox. However, if you haven’t had chickenpox and come into contact with someone with shingles, you can potentially get chickenpox from them, not shingles.
Adults that don’t know if they had chickenpox as a child can have this determined by a laboratory test. Chickenpox is much less common now than it was before a vaccine became available, so parents, doctors, and nurses are less familiar with it.
The reactivation of the varicella-zoster virus may occur as a result of lowered immunity. This may be due to infections, age, or having a weakened immune system due to medical treatments or disease. And while stress may not directly cause or trigger shingles, there is a link between the two. Large amounts of stress can wear away at the body’s immune system, lowering its ability to defend against all sorts of viruses—shingles included,
Shingles symptoms typically manifest as a painful rash that appears on one side of the body or face. It often starts as a tingling or burning sensation in a specific area, followed by the development of a red rash and fluid-filled blisters. Other symptoms can include fever, headache, and sensitivity to light.
Treatment for shingles include antiviral medications (such as acyclovir, valacyclovir, or famciclovir) which are commonly prescribed to reduce the severity and duration of shingles if started early (within 72 hours of rash onset). Pain relievers, topical treatments, and anti-inflammatory medications may also be recommended to manage pain and discomfort.
While shingles is usually not life-threatening, it can cause
severe pain and discomfort. In some cases, complications such as postherpetic neuralgia (persistent pain in the affected area even after the rash clears), vision loss (if the rash occurs near the eye), neurological problems, and skin infections can occur, especially in older adults or individuals with weakened immune systems.
The best way to prevent shingles is through vaccination. Shingrix is the preferred vaccine recommended by the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO). Shingrix is a non-live vaccine made from a recombinant protein and is highly effective in preventing shingles and reducing the risk of complications. It is given in two doses, usually 2 to 6 months apart.
The CDC recommends Shingrix for adults aged 50 years and older, including those who have previously had shingles; adults who are unsure if they had chickenpox; or adults who received the Zostavax vaccine. Zostavax was the first shingles vaccine available, which contained a weakened live virus. It is no longer recommended or available in many countries due to concerns about its effectiveness and potential side effects.
The effects of the Shingrix vaccine last for at least four
• Get a handle on how much you have saved and how much your will need to retire.
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years in most people and may last even longer in some. According to the CDC you do not need a booster dose after getting the two doses of Shingrix.
Shingrix is widely available in pharmacies and healthcare settings where vaccinations are offered. It’s advisable to check with your healthcare provider or local pharmacy to inquire about availability and any costs associated with receiving the vaccine.
The cost of the shingles vaccine can vary depending on your location and healthcare provider. In many countries, including the United States, the vaccine is covered by health insurance, Medicare, and Medicaid for eligible individuals. Some pharmacies and healthcare providers may also offer the vaccine at no cost under certain public health programs or during specific vaccination campaigns.
Getting vaccinated against shingles is highly recommended, especially for adults aged 50 and older, to reduce the risk of developing this painful and potentially debilitating condition. While there is no cure, prompt treatment with antiviral medications can help reduce the severity and duration of symptoms. It’s important for individuals who suspect they have shingles to seek medical attention promptly to minimize complications and discomfort.
By Char Adels, PA from Jefferson Healthcare
(206) 375-4002
(855) 734-1500
Daphne Davis, Owner
Technology has revolutionized healthcare delivery, making it more accessible and convenient than ever before. Jefferson Healthcare is among local healthcare organizations that have embraced this innovative approach, with virtual visits allowing patients in East Jefferson County to receive topquality primary care from the comfort of their homes.
Beyond standard primary care needs, patients looking to schedule their Medicare Annual Wellness Visit can also turn to virtual visits for fast, convenient care.
www.pinnacleseniorplacements.com
Char Adels, a Physician Assistant at Jefferson Healthcare, described the benefits and options of virtual visits in a recent episode of Jefferson Healthcare’s To Your Health podcast. Adels said “Telemedicine is very quick, efficient, and convenient. Patients can save time by avoiding travel and waiting rooms, making healthcare more accessible to everyone, regardless of their location.”
The convenience of virtual visits extends beyond just saving time. While the technology used by different healthcare providers may vary, Adels shares that the platform used by Jefferson Healthcare is straightforward and user-friendly. According to Adels, “you really don’t have to be too technical” to access a virtual appointment.
Adels explains that anyone with a smartphone, computer, or tablet with an internet connection can easily connect with their primary care provider, ensuring a seamless experience.
“There are so many busy working professionals who are unable to take time away from work to make it to a doctor’s appointment,” she notes. Virtual visits offer a solution for these individuals, allowing them to attend appointments without disrupting their work schedules. Additionally, “busy moms and dads who are staying at home with kids all day” find virtual visits particularly convenient, as it eliminates the need to pack up the children and travel to a doctor’s office.
Virtual visits with a health care provider are also a valuable option for those with mobility issues or who no longer drive. “It’s just a lot easier for them to stay at home and access healthcare from there,” explains Adels. This aspect of virtual visits ensures that even the most vulnerable populations can receive the care they need without the added stress of transportation.
Medicare Annual Wellness Visits: A Perfect Fit for Virtual Visits
Medicare recipients in particular can benefit from virtual appointments. Medicare covers an annual wellness visit at no cost to the patient, which can often be conducted virtually. These wellness visits are an opportunity for patients and their healthcare team to create a Personalized Prevention Plan. This plan includes planning for preventative screenings for conditions such as diabetes, cancer, and depression, discussing current medications, ordering labs related to preventative care, and discussing advance directives and risk assessments.
With a virtual visit, patients can also make plans for
Here are some tips to help you prepare for a virtual doctor visit:
• Talk to your provider ahead of time and set an agenda.
• Take notes during your session and be prepared with questions prior to your meeting.
• Check to see how your insurance will cover the appointment.
• Make sure your technology is prepared.
• Have some basic equipment on hand.
• Find a private spot where you can communicate clearly and without disturbance.
next steps and future visits with their provider. For example, patients can schedule immunizations, such as Flu, COVID-19, and Pneumococcal vaccines. By arranging and discussing these future plans, patients can put their Personalized Prevention Plan into action.
to Patients’ Wellbeing
By harnessing new technology, healthcare providers are working to ensure equitable access to quality services for their patients nationwide. Virtual visits offer a viable alternative to in-person visits, making healthcare more accessible and convenient.
To learn more about virtual appointments at Jefferson Healthcare and how they can help you safely and conveniently access high-quality care, visit their website or listen to the To Your Health podcast featuring Char Adels. As Adels succinctly puts it, virtual visits are “a very quick, efficient, and convenient” way to get the care you need, wherever you are. Ask your primary care provider if virtual visits are available for you and your family.
Jefferson Healthcare, 360-385-2200, 834 Sheridan St, Port Townsend, WA., https://jeffersonhealthcare.org/
Today, there are more than 6 million Americans living with Alzheimer’s disease, including 127,600 in Washington alone. However, only half of those with the disease ever receive a diagnosis. This delay in care can potentially put these individuals at risk. Close family members, who know their loved ones best, are typically the first to notice memory issues or cognitive problems, but they are often hesitant to say something—even when they know something is wrong. It can be hard to know whether something is an early sign of Alzheimer’s or dementia and can be a tough topic to approach.
Recognizing the early signs of Alzheimer’s is crucial for timely intervention. Here are the ten warning signs to look out for:
1. Memory loss that disrupts daily life: Forgetting recently learned information, important dates, or events, and repeatedly asking for the same information.
2. Challenges in planning or solving problems: Difficulty developing and following a plan or working with numbers. Problems following familiar recipes or keeping track of monthly bills.
3. Difficulty completing familiar tasks: Trouble driving to a familiar location, managing a budget at work, or remembering the rules of a favorite game.
4. Confusion with time or place: Losing track of dates, seasons, and the passage of time. Forgetting where they are or how they got there.
5. Trouble understanding visual images and spatial relationships: Difficulty reading, judging distance, and determining color or contrast, which may cause problems with driving.
6. New problems with words in speaking or writing: Trouble following or joining a conversation and struggling with vocabulary. They may have problems finding the right word or refer to things by the wrong name.
7. Misplacing things and losing the ability to retrace steps: Putting things in unusual places and being unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing.
8. Decreased or poor judgment: Experiencing changes in judgment or decision-making, especially when dealing with money or neglecting grooming and cleanliness.
9. Withdrawal from work or social activities: Removing themselves from hobbies, social activities, work projects, or sports. They may have trouble keeping up with a favorite team or remembering how to complete a favorite hobby.
10. Changes in mood or personality: Becoming confused, suspicious, depressed, fearful, or anxious. They may be easily upset when out of their comfort zone.
The Role of Family in Early Detection
Family members are often the first to notice these signs. It can be a daunting task to voice concerns, especially when
worried about causing distress. However, early detection is vital. If you notice one or more signs in yourself or another person, it’s important to act. These significant health concerns should be evaluated by a doctor.
Benefits of Early Detection. Early detection of Alzheimer’s disease provides several benefits, including:
Timely Access to Treatment: Allowing individuals to receive the most benefit from available treatments, which can help manage symptoms and maintain quality of life longer. Medications can slow the progression of symptoms in some people, and non-drug interventions can also be more effective when started early.
Planning for the Future: Making decisions about care preferences, living arrangements, and legal and financial matters while the individual is still able to participate in these decisions.
Access to Support and Resources: Connecting individuals who have Alzheimer’s and their families to community resources and support services. These can include educational programs, support groups, and respite care, all of which are invaluable in managing the disease.
Participation in Clinical Trials: Participation in clinical trials can offer access to new treatments and contribute
Continued on next page
• Don’t take long strides
• Avoid areas where ice removal is incomplete
• Select appropriate footwear
• Use caution when getting in or out of a vehicle
• Keep hands free for balance
• Use handrails when available
• Wipe your feet when entering buildings
• Walk with slightly bent knees
• Walk flat footed
• Don’t walk fast
• Bring a cane or walking aid if necessary
to research that will benefit future generations.
Reduced Anxiety: Knowing the diagnosis can help relieve the anxiety of not knowing the cause of symptoms. It allows individuals and families to understand what is happening and take control of the situation.
Improved Safety: With a diagnosis, steps can be taken to ensure the safety of the individual with Alzheimer’s. This might include modifications to the home, driving assessments, and other measures to prevent accidents and injuries.
Discussing changes in memory or behavior with a loved one can be challenging. Here are some tips to make the conversation easier:
Choose the Right Time and Place: Find a quiet, comfortable place where you won’t be interrupted.
Express Concerns with Empathy: Use “I” statements to express your concern. For example, “I’ve noticed you’ve been having trouble remembering things lately, and I’m worried about you.”
Be Prepared for Resistance: Understand that your loved one may be defensive or in denial. Be patient and try not to argue.
Encourage Medical Evaluation: Suggest a check-up with a doctor to rule out other possible causes of the symptoms.
Offer Support: Let them know you’re there to support them and that they don’t have to face this alone.
If you notice signs of Alzheimer’s in yourself or a loved one, it’s important to see a doctor for a thorough evaluation. The doctor can conduct tests to determine whether the symptoms are due to Alzheimer’s or another condition. An early and accurate diagnosis ensures appropriate treatment and support.
Early detection of Alzheimer’s disease is critical for accessing new treatment options, planning, and improving the quality of life for those affected. By recognizing the warning signs and taking prompt action, families can navigate the challenges of Alzheimer’s disease with greater confidence and support. Don’t hesitate to voice your concerns and seek medical advice if you notice changes in memory or behavior. Early detection is the key to unlocking the best possible outcomes for individuals with Alzheimer’s and their families.
Alzheimer’s Association of Western WA, 24/7 Helpline 800272-3900, www.alzwa.org
More than one in four people age 65 years or older fall each year, yet many falls can be prevented.
By Bonnie Dickson
t’s fall and that’s when we talk about falls. Why focus on falls every single year? Because one in four people over the age of 65 falls each year and many of those falls can be prevented.
Older people fall for many of the reasons younger people fall. Because they are unsteady on their feet, because of their medications, and because of other health issues. What’s important to understand is that people of all ages experience balance issues. But older adults experience real life-threatening issues if they fall and generally, unless the younger person is experiencing balance issues due to a medical condition or alcohol, younger people just get up and go again. Who doesn’t recall as a child spinning and spinning until the world completely swung off its access? It’s no longer fun though when it happens involuntarily.
Your inner ear, your vision, and your skin, joints, and muscles all work together to control your sense of balance.
The vestibular labyrinth in your inner ear is filled with fluids that help detect head movement. There are three canals, and they are oriented to a different plane, allowing you to detect different types of head movement. Also, a part of the vestibular labyrinth is the otolithic organs. They help detect linear accelerations and head positions relative to gravity and are essential for maintaining balance and spatial orientation. This system is key for preventing motion sickness because it helps your brain interpret and respond to motion signals.
Your vision sends impulses to your brain to show where you are in relation to other objects. People who have had their vision restored can sometimes experience balance issues because the brain requires time to adjust to the new visual input and re-integrate it with other sensory information. But it works the other way too. If you are losing your vision because of an injury, eyestrain, incorrect eyeglass or contact lens prescription or because your eyes are misaligned the brain receives conflicting information as it tries to make sense of your surroundings. Common problems of vision-related balance problems include blurry or double vision, concussion, blindness in one half of the visual field, and involuntary and repetitive eye movements.
Your body sends messages to your skin, joints and muscles that tell your brain where it is in relation to other things.
For example, leaning against something sends different messages than standing straight. People with vertigo can feel as if they are moving when they are holding perfectly still. That’s how adults can fall out of bed for instance.
Your central nervous system pulls the information from these three areas to tell your body how to maintain balance. When something interferes with any of these processes you can feel unsteady. This can happen at any age but certain types of health issues that are most prevalent in older adults can exacerbate the issue.
Medical conditions that may impair your sense of balance include Alzheimer’s and Parkinson’s disease, cardiovascular disease, low blood pressure, thyroid disease, diabetes, head injuries, peripheral neuropathy, headaches or migraines and motion sickness.
It’s important to understand that some balance issues can be addressed so it’s a good idea to speak with a health care provider to see if the symptoms or underlying condition can be treated.
Beyond getting medical help, you can also:
• Maintain a healthy weight.
• Drink plenty of fluids.
• Strengthen your core. Yoga and other exercises will strengthen your abdomen and help you stabilize your body.
• Fall proof your surroundings. Remove tripping hazards, keep areas well lit and use handrails. Don’t wear high heels.
• Take your time. If you are getting up, give yourself time to get used to your new position before starting to walk, and start walking slowly.
A physical therapist may be able to provide exercises that address balance disorders.
If you have balance issues, talk to your doctor about whether it’s safe to drive and about ways to lower your risk of falling during daily activities.
The good news is that falling is mostly avoidable. Take steps to help you remain safe this fall and throughout the year. It will keep you out of the hospital and allow you to continue being active.
By Mary Coupland
Ihave a white noise in my ears at times. What is that? Can I make it stop or will I always live with this? Does it mean I have a hearing problem, or will I develop one?
Great questions. It sounds like you may be experiencing tinnitus, sufferers often describe it as a ringing, buzzing, hissing, or whooshing sound in the ears. Tinnitus can indeed be bothersome, but it’s not usually a sign of a serious underlying condition. However, it can be a symptom of an underlying problem such as hearing loss, exposure to loud noises, earwax buildup, or certain medical conditions.
Whether you can make it stop or not depends on the underlying cause. In some cases, addressing the underlying issue, such as removing excess earwax or treating an ear infection, can alleviate tinnitus. However, in many cases, tinnitus is chronic and may not have a cure. But there are management strategies that can help reduce its impact on your life, such as sound therapy, cognitive behavioral therapy, relaxation techniques, and avoiding loud noises.
Dr. Rachael Cook, audiologist at Applied Hearing Solutions in Phoenix, Arizona talks about 5 of the Top Ways you might be making your tinnitus worse, and she offers solutions on how to make improvements:
1. Caffeine & Nicotine Consumption - both caffeine and nicotine are psychomotor stimulants, meaning that they really supply that get up and go feeling for many people. One risk of these stimulants is increased blood pressure, which often results in an increase in tinnitus perception. This is because the function of the cochlea, your hearing organ, depends heavily on the oxygen it gets from consistent blood flow. Higher blood pressure
can restrict the opening of blood vessels supplying the cochlea, limiting blood flow and oxygen and increasing tinnitus perception. If your tinnitus seems to spike at certain times of the day, you’ll want to take note of how much caffeine or nicotine you’ve already had and adjust your intake accordingly.
2. Taking Common Medications - Pain relievers like aspirin, ibuprofen, and naproxen, high dose antibiotics, loop diuretics and anti-depressants can all increase tinnitus perception. They can become more permanent with higher or more long-term dosages. If your tinnitus seems to increase while taking any of these medications be sure to talk to your doctor and your pharmacist to see if any alternatives exist for your situation.
3. Alcohol & Salt Consumption - Alcohol and salt both change the concentration of fluids within the cochlea that need to remain in the right balance to function correctly. Alcohol concentration change can certainly change the behavior of your tinnitus, often resulting in an increase in tinnitus perception while the alcohol remains in your system. Alcohol also changes blood flow patterns and neurotransmitter production in the brain that both impact tinnitus perception. And for many people, high levels of salt can also replicate these effects on tinnitus, seeming to increase after high salty snacks or meals. If a drink or a salty snack after work is a part of your evening routine, make sure to pay attention to the impact that this has on your tinnitus. You can adjust your routine to reduce or remove this habit, or at least benefit from the knowledge that drinking or eating high salt foods will very likely cause an increase in your tinnitus. Oftentimes, just knowing to expect an increase in your tinnitus is enough to remove the negative emotions
around a tinnitus spike.
4. Poor Sleep - I know it’s a vicious cycle when poor sleep contributes to tinnitus perception because oftentimes it’s tinnitus is what makes it more difficult to fall or stay asleep. However, poor quality or inconsistent sleep can increase your stress levels, making it harder for the brain to ignore tinnitus signals. It’s no surprise then that your tinnitus may sound louder after a night of poor or very brief sleep. This is especially true with sleep disorders like sleep apnea and insomnia. Be sure to talk to your doctor about any conditions that you find are impacting your sleep. View my video on sound therapy strategies that can make it easier to fall asleep and stay asleep, (338) How to ELIMINATE Your Tinnitus Using Sound Therapy - YouTube (https://youtu.be/BH ptfXs8Ac0?si=3ucOOnAIJzzQlDWT). If your tinnitus is stopping you from falling or staying asleep, then you must absolutely see an audiologist that specializes in tinnitus to evaluate your symptoms and discuss management so you can get a good night of rest.
5. Untreated Hearing Loss - Nearly 90 percent of individuals with tinnitus have some level of hearing loss, and if that hearing loss worsens over time, so too can the tinnitus. Seventy percent of people with tinnitus and hearing loss who treated their hearing loss using hearing aids alone saw a significant reduction in their tinnitus. This is likely because returning missing sound information to the brain helps to reduce internal signals trying to make up the difference, especially when combined with counseling and sound therapy. Strategies like tinnitus retraining therapy or progressive tinnitus management can result in considerable reduction in tinnitus perception.
“Overall, tinnitus is sensitive to many things. Knowing
Make an appointment to see your doctor if:
You develop tinnitus after an upper respiratory infection, such as a cold, and your tinnitus doesn't improve within a week.
See your doctor as soon as possible if:
You have hearing loss or dizziness with the tinnitus.
You are experiencing anxiety or depression as a result of your tinnitus.
more about your own triggers can help you to prepare for expected tinnitus changes and remain in control of your feelings towards it. Managing your tinnitus is totally possible once you begin determining which habits make your tinnitus better or worse, says Dr. Rachael Cook.”
While I was on YouTube, I came across this video by Dr. Rowe, a St. Joseph, Michigan Chiropractor. He shows an easy exercise that can give instant tinnitus relief, even within 30 seconds.
This exercise can be done at home, requires no equipment, and can be done throughout the day.
Here’s the link showing how it works One Move for Instant Tinnitus Relief #Shorts (https://youtube.com/shorts/ YyT9ZwWy5Jc?si=yaoTW_Y4fJKXYYoE)
And yes, I did try the exercise and will continue with it. Remember, experiencing tinnitus doesn’t necessarily mean you have a hearing problem, although it can be associated with hearing loss. It’s always a good idea to have your hearing evaluated by a healthcare professional if you’re experiencing tinnitus or any changes in your hearing. They can help determine the underlying cause and recommend appropriate treatment or management strategies.
By Deborah Kummerow & Lindsay Freitas
s the longer days and cooler nights of autumn set in, cold snaps, high winds, heavy rains, and ice are just around the corner. Our general contractor offers tips for winterizing your home. Tackle this list well in advance of the first frost!
• Prepare for power outages with a well-stocked emergency kit.
• Have your heating system serviced and replace furnace filters.
• Have your fireplace or wood burning stove cleaned and serviced.
• When your chimney is not in use, close the damper and flue to reduce heat loss.
• Clean out your rain gutters in the fall after the leaves have fallen.
• Turn off and drain water to outdoor faucets and apply insulated outdoor covers.
• Have your irrigation system winterized by an irrigation specialist.
• Disconnect, drain, and store garden hoses to prevent them from bursting or leaking during the winter.
• Check your door and window weatherstripping for necessary repairs and caulking. Apply window coverings to help keep heat inside.
• If your home is susceptible to water intrusion, make sure your sump pump is ready.
• Wrap plumbing pipes in unheated locations, such as the garage or crawlspace, using foam insulation, pipe wrap or heat tape. Protect water pipes and prevent them from freezing and bursting.
• Ensure you have adequate insulation, including in
your attic. Heat rises and will escape through a poorly insulated attic.
• Reverse your ceiling fans in the winter months-set them to rotate in a clockwise direction to spread warm air near the ceiling down into the room.
• Make sure outdoor areas are well lit.
• Keep outdoor walkways clear of ice and snow.
Deborah Kummerow & Lindsay Freitas, Kummerow Design & Construction, Inc. Contractor in Bainbridge Island, WA. https://kdcdesignbuild.com/
By Bonnie Dickson
There’s no science behind it but I’m just going to say it anyway. The world has gotten smaller. Even possibly a lot smaller. Twenty years ago, if you were looking to work from home your options were limited and mostly a scam. A Forbes article last year estimated that about 1 in 5 Americans work remotely. Now, you might be thinking that you aren’t concerned about working, although about 22 percent of Americans 65 and up are doing so but the point I’m trying to make here is that the ability to work from home can be translated into the ability to live anywhere in the world. The tech is there, the communication options are there. You can bank anywhere, talk to friends and family from anywhere, run a business, earn a living, buy a home and do it all anywhere.
But why would you?
People choose to live abroad for many reasons. The Italian countryside is warmer, the cost of living in Portugal is lower, medical care in pretty much any country is cheaper, transportation is easier in South Korea, you met the most wonderful person in the world, and they are from Japan or you’re going back to your Irish roots. Those are just a few options for leaving the familiar and leaving the familiar is often the biggest draw of all. Have a yen for seeing art in Venice, eating a baguette while sitting in the French countryside, drinking beer in Germany? And finally living in the US can cause us to be a bit insular. Moving to where the laws, language, food, and culture are unfamiliar will open your life to new, well really, everything.
What kinds of things do you have to consider?
Collecting your Social Security (SS) Benefits: People from all over the world come and work in the US and many of them are eligible for SS benefits. The Social Security Administration pays benefits to 760,000 beneficiaries outside the US. There’s no time limit on how long you can receive your benefits outside of the US if you continue
to fill out Form SSA-7162 either annually or biannually as required by contacting your Social Security office. Go to Your Payments While You are Outside the United States (May 2023) (ssa.gov) for a more comprehensive list of payments that can and cannot be made.
Outside of the US means not within the 50 states, District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa. If you are not a US citizen, you can use the screening tool at Payments Abroad Screening Tool | International Programs | SSA.
Apply for your SS benefits while still living in the US or you will need to visit the Federal Benefits Unit at a U.S. embassy instead. Social Security employees are not able to provide advice so seek an expert that handles overseas benefits to make sure you understand the rules and are maximizing your benefits.
Paying taxes: Wherever you live, you need to continue to pay US taxes annually. Because your new country doesn’t feel any differently about taxes, you also must file a second set of taxes in the new country. The US charges taxes on their citizens regardless of where they reside. There are tax treaties but not every state honors the provisions of tax treaties so you’ll probably need an expert. Pro tip here. If you live in a state that charges a state income tax, move to a state that doesn’t before making your new life as an expat. And finally, if you have money in a foreign bank, you will need to report it when you do your taxes.
You may need a Visa. Many countries require proof that you will not become a burden once you’ve moved abroad. That may mean proving you have money when you enter the country in addition to any visa requirements.
Decide where you want to live. Check out the Annual Global Retirement Index for inspiration at Best Places to Retire in 2024: The Annual Global Retirement Index
(internationalliving.com). Take time to research your dream locale and visit at different times of the year for prolonged periods.
Determine if you can retire there. Will you have to give up your US citizenship? Is the visa requirement just for a temporary residency, does it prevent you from working there, how long do you have to live there before you can gain permanent residency? What are the requirements for letting you live there before you can have permanent residency?
Get housed. Some countries have restrictions preventing foreigners from buying property. It can be difficult to get local mortgages and US banks often won’t approve bank loans for foreign properties. The embassy of the country that you wish to retire in can aid with finding information and lawyers who can help navigate the legal requirements. Verify that the things like household appliances that you would take for granted in the states are part of any renter’s or buyer’s options. Depending on the location you choose, getting those options may be excessively costly. Moving into any new housing requires expenses beyond your monthly expenses and may have to be paid for in cash so make a budget.
Healthcare needs to be thoroughly researched. Prior to moving to another country, sign up for Medicare and Medicare supplements as soon as you are eligible. If you come back to the US, you will have penalties if you get them after age 65 even though you won’t be able to use Medicare outside of the US.
Develop friendships. No matter where you choose to go, there will be an expat community. Don’t reinvent the wheel if there are ready and willing resources already available.
Factor in travel. Yes, you are in the place you most want to be but is your mom, dad, grandkids or other family members? Homesickness is real, gets referenced in nearly any article pertaining to living abroad and happens regardless of age or even of how happy you are in the new place. Make sure you can go home even if only for short periods of time.
For more information, consider, American Citizens Abroad, which among other things provides information, a podcast, and webinars for US citizens living and working overseas. Conde Nast has a list of resources here to address concerns, questions, and contacts with Expat communities.
is advice never expires. Re ect on your values and how you’d like your loved ones to facilitate your needs as you age. Do this with them while your health is good and each time your life changes. A child moves away? Your spouse passes? You sell property? Update your will, medical and nancial power of attorney as life changes so if something changes, your loved ones can act on your behalf.
Proactive planning outweighs reactive responses. Families o en struggle to know the best choices to make on behalf of their aging parents. Your family will thank you for the peace and unity it brings them when you have made and conveyed selections around your medical wishes, assets, and desired outcomes prior to the need for them. Selecting your advance directives (living will, durable power of attorney, do-notresuscitate (DNR), and do not intubate (DNI) orders) helps you to know your wishes will be honored and by providing them with the opportunity to meet with aging professionals, you will help them understand their responsibilities and set everyone up for success.
You are a whole, intricate person with many beliefs and values. You may have beliefs around how you’d like to interact with the environment and have a green burial, or you’d like to have an alter call at your funeral, or you’d like to make sure certain medical services are not something you experience; all these things can be incorporated and honored.
By Candace Meadows, Marketing Outreach Director www.northwestcare.com
Checklist For WA State:
Medical & Financial POAs
Advance Directives (living will, durable power of attorney, DNR, and DNI orders)
Funeral arrangements
Make sure your Independent/Assisted Living or Memory Care community has updated documents.
By Mary Coupland
Business law is the body of laws that govern how business organizations and business entities are established, run, and managed. The main goal of business law is to ensure that businesses operate legally and ethically within the framework of established rules and regulations. It is vital that a corporate entity follows all local laws, state laws, and federal laws.
Business law covers a wide range of topics such as contracts, property rights, intellectual property, employment law, corporate governance, taxation, securities, business formation and dissolution, consumer protection, environmental regulations, and many more.
Business law has many purposes. It helps ensure fairness in a business transaction between other businesses involved in a deal or dispute; it protects individual rights; it provides standards for responsible behavior; and it promotes economic stability through legal certainty.
Here Are A Few Types Of Business Law:
Contract Law: Covers agreements between entities or individuals, ensuring they are enforceable and legally binding.
Corporate Law: Deals specifically with the formation, governance, and operation of corporations, including issues like mergers, acquisitions, and shareholder rights.
Intellectual Property Law: Protects inventions, trademarks, copyrights, and trade secrets from unauthorized use or infringement.
Employment Law: Governs the relationship between employers and employees, covering issues such as hiring practices, workplace safety, discrimination, and termination.
Tax Law: Involves understanding and complying with tax obligations, deductions, and credits applicable to businesses.
Securities Law: Regulates the sale and trading of securities (stocks and bonds) to protect investors and maintain fair and efficient markets.
Antitrust Law: Prevents unfair business practices such as monopolies and price fixing, promoting healthy competition in the marketplace.
If you’re wondering if corporate law and business law are the same thing, the answer is that they are not exactly the same. Corporate law is a subset of business law that specifically deals with corporations — their formation, governance, and operation. Business law, on the other hand, is a broader term that encompasses all legal aspects of running a business, including corporate law, as well as other areas such as contracts, employment law, intellectual property, and more.
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If you are considering starting your own business or already own a business, consulting with an attorney can be highly beneficial, especially during the setup phase. When I launched Compass & Clock in 2018 I consulted with a business attorney and they were instrumental in outlining what the different types of business formations were and what the pros and cons were of each, especially as it pertained to tax structure and protection for myself and my personal assets. From there I was able to select the correct structure for my small business.
Here are some reasons why you should consult with a business attorney when forming a business or if you already own one:
Formation and Structure: Attorneys can advise you on the
most suitable legal structure for your business (such as sole proprietorship, partnership, LLC, corporation) based on your goals, liabilities, and tax considerations.
Compliance: Business attorneys help ensure that your business complies with federal, state, and local regulations. They can assist with obtaining necessary licenses and permits.
Contracts: Drafting and reviewing contracts is a critical aspect of business operations. An attorney can help protect your interests by ensuring contracts are clear, enforceable, and in compliance with the law.
Intellectual Property: Protecting trademarks, copyrights, and patents is essential for many businesses. A business attorney can help you navigate intellectual property laws and file necessary applications.
Employment Issues: From hiring practices to employment contracts and termination procedures, an attorney can provide guidance to ensure compliance with employment laws and regulations.
Lastly, business law can vary from state to state in the U.S. While many principles are similar across states due to federal laws and common law precedents, each state may
Hinson,
have its own specific statutes and regulations that govern certain aspects of business operations. Therefore, it’s important to consult with an attorney who is familiar with the laws in your state to ensure compliance and to protect your business interests effectively.
As a sole proprietor, you are personally responsible for all aspects of your business, including legal matters. While it’s not mandatory to become an expert in business law, it is highly advisable to seek the guidance of an attorney, especially for important tasks such as Business Formation (choosing the right legal structure); Contracts (drafting, reviewing and understanding contracts with supplies, clients, and others); Compliance (ensuring your business complies with federal, state, and local regulations, including licenses and permits); Liability (understanding your personal liability and taking steps to protect your personal assets); and Disputes (handling legal disputes that may arise, such as breach of contract or employment issues).
An attorney can provide valuable advice tailored to your specific situation, helping you navigate legal complexities and avoid costly mistakes. This allows you to focus on running and growing your business while ensuring that you operate within the bounds of the law.
By Colleen Mriglot
Most people would prefer never to have to hire a lawyer – they’re expensive and popular culture often portrays them as greedy bloodsuckers. (Sigh.) However, insurance companies are in business to make money, and this means paying out as little as possible on claims. In my experience as a personal injury lawyer, clients sometimes seek the services of an attorney after they have attempted to resolve a claim with an insurance company which has offered less than the medical expenses to settle the claim. This is not fair or reasonable. These offers usually provide no compensation whatsoever for physical pain, suffering, or emotional distress. Thus, there is a need to pursue a claim with a lawyer – and the earlier the better.
Personal injury claims are legal disputes that arise when an individual suffers harm from an accident or injury, and someone else may be legally responsible for that harm. Navigating a personal injury claim involves understanding the key components that define the process. Here is a breakdown of the anatomy of a personal injury claim:
The foundation of any personal injury claim is the occurrence of an accident or incident that results in injury or even death. This could be a car accident, trip and fall, workplace injury, medical malpractice, or any event where harm is inflicted on an individual due to another’s actions or negligence.
To proceed with a personal injury claim, it must be established that another party is liable for the injury. This involves demonstrating that the wrongdoer owed a duty of care to the victim, breached that duty, and caused the injury. Damages are also required to be proven. Key elements in establishing liability and damages include:
Duty of Care: The defendant had a legal responsibility to act in a certain way toward the plaintiff.
Breach of Duty: The defendant failed to fulfill their duty of care through actions or omissions.
Causation: The breach of duty directly caused the injury.
Damages: The plaintiff suffered actual harm or losses due to the breach.
Forensic experts often must be hired to prove liability and/or damages. These may be expert accident reconstructionists, biomechanical engineers, economists, and specialized physicians, among others.
It is important to seek immediate medical attention after an injury. Not only is this crucial for health and recovery, but medical records also serve as essential evidence in a personal injury claim. Comprehensive documentation of injuries, treatments/rehabilitation, and medical expenses will substantiate the claim for damages. If a person misses work due to pain, disability, or to get medical care, these damages are documented through employment records or witness statements.
Navigating the legal complexities of a personal injury claim often requires professional assistance. A personal injury attorney can evaluate the case, gather evidence, and provide advice on the best course of action. Attorneys typically work on a contingency fee basis, which means they only get paid if the claim is successful.
Insurance claims are usually filed early, while the victim is still treating. Once treatment has concluded and the nature and extent of injuries are known, a demand letter is submitted to the responsible party’s insurance company. This letter outlines the facts of the incident, the injuries sustained, the theory of liability, and the compensation being sought.
Most claims are settled out of court. This phase involves negotiation between the plaintiff’s attorney and the insurance company to reach an agreeable settlement. The vast majority of claims settle before initiating a lawsuit, and even less before a trial takes place. An effective negotiation will consider:
Medical expenses: Costs incurred for medical treatment in the past and/or future.
Lost wages: Compensation for past income lost and/or lack
of earning capacity (in the future) due to the inability to work.
Pain and suffering: Non-economic damages for physical and emotional distress.
Property damage: Costs to repair or replace damaged property.
Litigation
If a settlement cannot be reached, the case may proceed to litigation. This involves filing a lawsuit in court. The litigation process includes:
Discovery: Both parties investigate the facts of the case and exchange documents and information.
Depositions: Witnesses and involved parties provide sworn testimony.
Trial: The case is argued before a judge or jury, who then decide on the outcome.
If the case goes to trial, the court will issue a verdict. If the plaintiff wins, the jury or a judge determines the amount of compensation based on the evidence presented. This
compensation is intended to cover all the damages and losses incurred, and any future damages, if such evidence has been presented.
After a verdict, either party may choose to appeal the decision if they believe there were errors in the legal process. The appeals process involves having a higher court review the case and the initial court’s decision. The majority of cases are not appealed.
Understanding how a personal injury claim works is crucial for anyone who has suffered an injury due to someone else’s negligence. The process involves multiple steps - from documenting injuries to establishing liability and damages, to negotiating the settlement, and being prepared to go to trial. Navigating this process with the help of a knowledgeable attorney can significantly impact the success and compensation of a personal injury claim.
Colleen Mriglot, Attorney at Law, West Sound Injury Law, 206-842-5681, https://westsoundinjurylaw.com/
By Gary Floring
DEMOGRAPHICS. Various studies reveal some interesting facts about single Americans 50 and over. The well-known, respected Pew Research Center reported in February 2023 that 28 percent of men 50 to 64 years of age and 25 percent of men 65 years and older are single compared to 30 percent and 39 percent for women in those age categories, respectively. So, while the percentages are roughly equal among men and women in their early 50s, the percentages gradually increase for women, in part because of their longer lifespans. Modern medical technology is increasing lifespans for both sexes. This means older adults have more years ahead of them than ever before to spark new relationships.
DEFINITION OF “SINGLE.” As people 50 and older think about dating, it can be a unique feeling of curiosity, excitement, caution, and maybe even nervousness. Whether you’ve never married, are divorced, a widow(er), or have simply decided to explore new romantic possibilities, senior dating can and should be a rewarding experience. Just as in any stage of life, dating comes with its unique challenges and potential complications. Pew’s research defines “single” as those unmarried, not living with a partner, or not in a committed relationship.
ARE YOU READY TO DATE? At this point in life, it’s a given that potential dating partners will bring in what is sometimes referred to as “baggage,” both positive and maybe not-so-positive. For example, many seniors have reached financial security, possibly with large equity in their homes and investments. This allows more freedom to travel, with more time to explore hobbies, interests, passions, and discovering new horizons. At the same time, many seniors may have been through painful past relationships, or death of a partner, and still need time for grieving and recovery in order to move on. In these situations, it’s important to take full stock of yourself, to
determine if and when you are ready for dating and new romantic opportunities.
RELATIONSHIP GOALS. It’s also very important to figure out if you are just looking for casual dating with or without a sexual relationship, a serious long-term commitment, cohabiting, or even marriage. Whatever both partners are seeking should be clearly communicated early on, to ensure mutual compatibility and avoid any misunderstandings. It’s always best to be open and honest about what you want, before the dating phase moves into a more serious relationship.
ONLINE VS. ORGANIC DATING. Many years ago, dating apps began to draw singles from every age bracket, and many people found compatible partners for dating and more. However, many of these apps have become magnets for hackers and scammers, with fake profiles proliferating everywhere. Many dating advisers recommend using these apps only with extreme caution, if at all nowadays. Again, Pew Research reports that almost half (47 percent) of online daters ages 50 and older say they have encountered someone who they believed were scammers or fake personas. Online daters ages 50 to 64 are more likely than those 65 and older to have experienced this (52percent vs. 39 percent). Furthermore, among adults 50 and older who are married, living with a partner, or in a committed romantic relationship, only 6 percent say they met their significant other through online dating.
COMPATIBLE ENVIRONMENTS. You are more likely to meet well-matched dating partners in a natural, spontaneous situation, such as attending various events, hobby shows, and belonging to groups and organizations where potential compatibility is maximized. For example, if you love hiking, sports, and the outdoors, there are plenty of 50+ singles groups dedicated to this activity. The same goes with other activities such as live music events, dinners, dancing, boating, RV travel, volunteering, etc. There are many organized clubs and groups for these activities. One of the best ways to find like-minded dating partners is at www.meetup.com. There, you are more likely to find several compatible groups of singles to mingle
with while enjoying similar activities in a safe environment. The popular social media site www.facebook.com also has organized singles groups for various interests. It’s always safer to join groups rather than initiating or responding to individual messages.
SAFETY FIRST. When it comes to safety, always be on the lookout for dating “red flags.” These may include:
- Lack of Communication. Be cautious if your date is evasive, avoids discussing their past, doesn’t talk about their friends or family, or seems disinterested in getting to know you on a deeper level.
- Inconsistency. If a dating partner is warm and affectionate one moment but distant or unavailable the next, it could be a sign of underlying issues or an unwillingness to commit. Be wary of any drastic changes in behavior.
- Financial problems. Be wary if your partner consistently needs money or engages in reckless spending habits. It’s important to protect your financial well-being and ensure that your dating interest is not trying to take advantage of your financial independence.
- Rushed Intimacy. While it’s natural to seek
companionship and physical affection, remember that building a strong emotional connection should come first. If your dating partner pushes for physical intimacy too soon or seems overly focused on it, it could be they are not interested in a genuine relationship.
- Isolation. A potential partner should encourage you to spend time with your friends and family. If not, that could be a sign of controlling or manipulative behavior. Healthy relationships should recognize a balance between your social life and your romantic one.
SUMMARY. Ultimately, if something doesn’t feel right or you sense your dating partner may not have your best interests at heart, trust your instincts and intuition. Dating at 50 and over should be a positive, enriching experience, and you deserve to be with someone who makes you feel safe, respected, and cared for. It should be a wonderful opportunity to find compatibility, companionship, and happiness; an enjoyable journey of mutual-discovery and connection. Keep your standards high, and never settle for less than you deserve. Approach dating in your golden years with both attentiveness and an open heart.
Gary Floring, We Know Medicare 101 Professional, 360.633.7626, https://weknowmedicare.org/gary-floring/
By: Lisa Kemmerling
September through December are my favorite months of the year. The weather starts to change, and our oppressive summer months start to “fall” behind us. Most people look forward to breaking out their sweaters to accommodate those cooler evenings. Jeans make their way back into our closets and for those individuals who love corduroy, the colors pop as fall rushes in. Living in the desert, sometimes fall doesn’t appear until late October and then only for a short time as the leaves turn golden brown, and the grass goes to hazy green.
For a fashion fanatic like me, the stores start displaying new fall fashion colors in July/August, which seems ironic as fall has typically been September through November. The coveted fashion show of Magic shows all the fashions that will appear in stores in the coming 6 months. That said, some fabulous colors for the season are Fiery Red, Clay, Viva Magenta, Bone, Burgundy and my personal favorite Chocolate Brown. Seeing these colors has inspired me to take the most mundane of outfits and pop them with a spot of color.
For even the most conservative individuals, if none of these colors suit a wardrobe refresh, then perhaps a less risky approach would be in a hat or a coat for Fall 2024.
An exciting new look has been introduced this season with the “shirtdress.” So, what exactly is a shirtdress? It is defined as a dress with a collar and buttons in the style of a shirt, typically cut without a seam at the waist. It’s very collegiate, but also a classic as it can be paired with tennis shoes, sandals, or low pumps. No need for anything else, unless of course you need a sweater draped over your shoulders to take off the evening chill. The best part of this fresh look - it’s a flattering figure for all women. Traditional fall colors have been beige, taupe, gray, navy, black and burgundy. This year many of the new colors will incorporate browns, and bronze for both men and women.
Culottes are making their way back onto the rounders for fall. I’m often asked what culottes are. Their origins begin with aristocrats and military men and goes as far back as the early 1900’s. Recalling an annual shopping trip with my mom for the latest and most fashionable styles in the late ‘70s brought me to my first introduction of the culotte. Standing in front of the mannequin and seeing these very chic pants displayed with a shirt and V neck sweater, I knew at once that this was going to be my new look for my first day in high school.
Leaning into the fall colors, it’s evident that most of the stores are showing these staples in either solid or a print. For many individuals taking on the challenge of a patterned shirt or sweater in multi colors can be scary at best. Personally, I love a challenge and seeing the new herringbones or a beautiful burgundy, beige and brown style sweater paired with a great pair of slacks or a skirt, makes my heart soar. With Fall 2024 right around the corner, take that leap of faith and try something outside of your comfort zone, by finding a scarf, blouse or sweater that doesn’t break the budget. Maybe the multi-colored sweater isn’t one’s cup of tea; however, the color of navy has been a long-standing staple and pairs beautifully with cream, bone and yes, even fuchsia. Saying goodbye to summer is always difficult; however, the fall season not only brings weather changes, but a wonderful sense of comfort and warmth. Maintain a positive outlook on life and realize that even the simplest of things can offer a feeling of joy. Happy fall y’all and enjoy the changes of the season.
Lisa Kemmerling, owner of Clean Lines Fashion Consulting / lisa@cleanlinesfashion.com or (925) 518-4950, https:// www.cleanlinesfashion.com/.
By Bonnie Dickson
bout 15 percent of Americans have done a DNA test using a mail-in service. Americans are far more likely to do a DNA test than any other country, about 89 percent of total shares of testing as of 2021. I have a totally unscientific belief it is because most of us are immigrants. I can trace my family back about 100 years, give or take, whereas many countries take great pride in knowing something of their family history from generations ago. I recently talked to a man with a last name of Tea. That seemed like a very specific name, so I asked him and he was able to say that about 10 generations ago, his greatgreat-great times many grandfather grew tea and was famous for it. If you are like most Americans, you can say that you had someone in your past about that long ago. Period.
American geneticist, Spencer Wells, once said, “Anybody have a member of the family, or maybe you have tried to construct a family tree, trace back in time? You start in the present, with relationships you’re certain about. You and your siblings, you have a parent in common. You and your cousins share a grandparent in common. You gradually trace further and further back into the past, adding these ever more distant relationships. But eventually, no matter how good you are at digging up the church records, and all that stuff, you hit what the genealogists call a brick wall. A point beyond which you don’t know anything else about your ancestors, and you enter this dark and mysterious realm we call history that we have to feel our way through with whispered guidance.”
The kind of DNA test that would be super useful isn’t possible because scientists for the most part don’t have genetic material from people 400 years ago or a thousand years ago. They have you, and maybe a cousin or two, maybe a grandparent like Wells said. But, I did a test anyway. Because I wanted to know, maybe even need to know, where do I come from?
There were other reasons I wanted to know. My dad has a picture of his grandfather, grandmother and their children. I don’t remember if my own grandfather was yet in the picture but it is one of those old pictures that everyone had to hold real still for because the exposure time was long. In the photo I can see several children, a man who is so tall
that even though he is sitting and my great-great mother is standing, he towers over her. It’s possible that under exposure makes my great-great grandmother darker than what she was but I wanted to know, did I have something other than European blood in my veins. Not because I care if I do or don’t but because I don’t have that part of the narrative. I also wonder that someone in my family was ever tall because we are short people. Maybe he wasn’t tall, maybe my great-great grandmother was ridiculously short. The only other comparisons I have in that photo is with a bunch of children after all.
I sent off my cheek swabs and waited. When you want something, it takes much longer than you expect it to but it took about a month or so. Then I got my results back. I’m 35 percent Germanic background, which I had some inkling of but there were surprises too. My great-grandfather came over from Scotland so the German and English weren’t so surprising but who were the Hungarian, Polish, Italian, Spanish, Russians and whatall else?
So, was that all I learned? Nope. I can’t say that I learned a ton or even much about individual members of my family, partly because the test I took didn't go down that road. Maybe sometime in the future I will want to know about any long lost relatives but that wasn't my aim. I did learn about my blue eyes, lack of freckles, and other things, most of which I knew but it was weird to see that my DNA determined whether I was sensitive to caffeine or not for instance. A friend of mine was adopted and he did a DNA test to find family members from his birth family so he went with a different test. His test gave him answers of a different sort. The interesting thing is that both of us were happy with the kinds of results we received.
Would I recommend that you do a DNA test? I’d say, first determine what you are trying to learn from the test because frankly if the vast majority of people who do a DNA test are Americans, you’re going to find some big holes. My test was able to go back to about 1700 with a confirmed or mostly confirmed relative (they don’t report anything less than 80 percent likely) but it’s best to keep in mind that results are dependent upon sample size and so far sample size is pretty darn small.
What can you learn from a DNA test?
You may be able to trace your family ancestry back further than traditional genealogy records. You may find out where
you and your family come from and when your family arrived at specific locations.
You may find out information about you specifically like my blue eyes and lack of freckles and a preference for tea over coffee.
You can learn something about your health. What you have a genetic tendency towards and what you don’t.
You may discover relatives. My test listed two famous people. Since one was from about 1400 AD, I can’t hit them up for a loan though.
How do you choose?
The best companies are 100 percent privately owned rather than being owned in part or in whole by pharmaceutical and/or insurance companies. Read reviews and make sure that you aren’t buying into a marketing strategy rather than geneticists’ research. You want a company with professional scientists.
Find one that gives you more than a percentage of what ethnic group you are. You want to be able to relate your results with something about where you came from and when they got there.
Here’s a video (https://www.youtube.com/ watch?v=R4jZvfbEmZo&t=18s) that compares 10 DNA testing companies and goes in depth on price, what’s covered and some nice explanation about what the tests do and how they perform the tests. It is super useful for trying to break down which test to purchase if you are thinking about expanding your knowledge about you.
What did I learn? Data is king but survey size is everything. If you wait a couple years, every genetic testing company will have a bigger survey size and therefore be more useful, so waiting in this instance may prove more beneficial. You can spend a ton of money or a fairly small amount of money, around a hundred dollars or so. It really is important to know what you want to find out. While, the results are important, I would advocate for one other thing. Research what happens to your data. This is one time it is going to be really important to understand the privacy policy. This is some of your most personal information. Don't trust just anyone with it.
Finally, while I didn't get all my answers, I did get pieces of me that were lost. I'm looking forward to discovering more.
solved the problem at home until the mid-1960s, even going so far as to drop programs and now like a bad relative, it’s back.
Hunger might be a symptom of food insecurity, but food insecurity is not hunger. We don’t talk about starvation or hunger much anymore. We’ve changed the terms for better or worse to high food security; meaning those that don’t worry about food, to marginal food security; meaning those who don’t experience a change in their diet but have occasional anxiety about having enough food to those on the other end with food insecurity: low food insecurity; meaning folks that eat a lower quality diet and have less variety but don’t overall have less food to eat: and finally to very low food security; meaning their food intake has been reduced or interrupted.
In 2011, the US dropped to one of the worst out of 20 economies that were studied in a piece by The New York Times called ‘American Shame.’ The good news is that the US has studied and attempted to prevent hunger in America for a long time and so should have a leg up on what works and what doesn’t. The bad news is that we have largely failed. So, why is it that when we have focused on it for so long, when we produce more food than our population needs, when we have abundant fertile land, and when food in America is historically cheaper than anywhere else in the world, that people still go hungry? And, why do we care about it in this magazine?
By Bonnie Dickson
hen I was growing up, I was well aware that there were starving children in Africa. Since everyone here is at least my age or older, I bet you were too. “Finish your dinner, there are starving children in Africa,” my mom would say. In fact, there were plenty of ads with miserable children who were too emaciated and too worn by the effort of living whose faces were in ads and in news stories in case we had any doubts. Historically, the US has been a world leader in reducing hunger both here and abroad, even if our attempts at both have been somewhat ham handed. One sociology professor, Janet Poppendieck, wrote in “Sweet Charity?: Emergency Food and the End of Entitlement,” that the US thought we had
I think those are really good questions. Let’s look at the last question first. A 2022 study from Feeding America, the largest hunger-relief program in the US, estimated that one in 11 adults 60 and older faced hunger in the US, that’s about 7 million older adults. Because you cannot be healthy if you don’t have food, food insecurity isn’t just a problem for the individual, it’s a problem for communities. Low-income seniors with health issues often end up getting care in places that are paid for or subsidized by taxpayers.
The absolute best resource allowing someone to age at home is their health. Healthy people spend less money, time and effort on housing, medical care, insurance, and just about everything necessary for life. One key finding from the study was that “Food insecurity exacerbates many of the unique health, economic, mobility and nutritional challenges that can come with aging. This is especially true for those with disabilities. Seniors with a disability had food insecurity rates over twice as high as seniors without disabilities. For older adults, the disparity is even greater. Older adults with disabilities had food insecurity rates more than three times as high as older adults without disabilities.”
Older adults with food insecurity have higher rates of mental health issues such as stress or depression, are more likely to suffer from congestive heart failure, high blood pressure, asthma, obesity, and gum disease, and are more likely to have malnutrition. And not surprisingly, they live shorter lives, according to a recent Journal of American Medicine Association (JAMA).
What can we do about it?
The main cause of food insecurity is poverty. Low wage earners spend nearly a quarter of their earnings on food. Other costs that squeeze that amount include housing. The common rule of thumb is that wage earners should spend no more than 30 percent of their paychecks on housing, but the Pew Research Center found that 23 percent of Americans spent at least 50 percent of their income on housing. Another 35 percent is spent on health care. And with no other costs, such as transportation expenses, clothing, taxes, or other incidentals, it becomes apparent why we have food insecurity in America. The numbers don’t add up to a doable option. When people have to decide between food and medicine, the outcome is always going to be unhealthy people, one way or another.
Poverty USA recommends the following solutions:
Work to modernize SNAP benefits so that they better represent needs. Because SNAP benefits are the same across the country, people who live in areas with higher expenses have less money available.
Reduce American food waste to a number that matches other countries. Currently Americans waste about 30-40 percent of food, but the rest of the world wastes closer to 30 percent. One issue is the best-by, use-by, and sell-by dates that often leads to discarding perfectly good food.
Offer free school lunches for everyone so that there is no stigma from making use of the school lunch program.
The problem with these suggestions is that they remind me of financial planning seminars for the poor that begin with cut back on the number of Starbucks coffees you drink and don’t go out to eat one day a week. I don’t see how they positively contribute to the success of lowincome people.
I can’t be the only one who sees cartloads of processed food being paid for by SNAP benefits. The Foundation for Economic Education claims that people spend about 20 percent of their benefits on junk food and 27 percent less on fruits and vegetables than non-SNAP households. Worse, NBC News, in a 2021 article noted that SNAP
benefits are dictated by the Thrifty Food Plan, which is woefully out of date as it hasn’t been updated since 1975.
I don’t imagine people who are food insecure get to the point that they are throwing food out because of a date. And the US doesn’t have a food shortage. We are still sending plenty of food to other countries.
Free school lunches have their place but ask any school and they are always trying to find ways to feed children during school breaks such as weekends, holidays and summer. Feeding a child 1-2 meals a day for 5 days a week when they need food for 3 meals a day, 7 days a week and so do their non-school aged siblings and parents seems a bit like throwing rocks in the ocean.
The greatest solution is to eradicate poverty. But here are a few others:
Volunteer at a food bank, co-op, gleaning project, community garden or soup kitchen. You’ll get a feeling for who those faceless people are that we talk about when we talk about food insecurity. But you’ll also be involved. My neighborhood has a food pantry that someone put up just like the free libraries. When my neighborhood is flush, it’s filled with food items, when we aren’t, it’s filled with bags of beans and macaroni. Teaching someone how to use those bags of beans and macaroni might be another great option since nearly every food bank includes them in the mix of items they send home with people. Home Economics used to be a required class, maybe it’s time we bring it back. Several people in my neighborhood have also put up tables for excess food. When gardening season is upon us, neighbors can take home fresh grown zucchini, cucumbers, tomatoes etc. It doesn’t do much for the winter months but being able to preserve food is as easy as a Google search or a stop at the local library and because poor people have been doing it for eons, it's accessible. Volunteer with gleaning projects, you'll get food and so will someone else. What's more it will be food that might have gone into the waste stream so you are solving three problems at once.
Vote. Speak with your representative. Make some noise. I attended the opening of a community garden years ago, and my representative was there. I took her aside and spoke to her about how we had so few options for just getting food. At the time there was a minimal 3-mile bus or car ride to get to the nearest food store. I was surprised to find it was something she cared about as well because her mother lived in my neighborhood. Having a store close by doesn’t fix anything if you have no money but if your grocery store is the local 7-Eleven you are paying too
much for your daily food intake and it won’t be nutritious. I bring up food deserts because it’s something I care about but you might want to consider becoming a voice for a government benefit. Supplemental Security Income (SSI) has an asset limit of $2,000 for individuals and $3,000 for couples and hasn’t been adjusted since 1984. For every other kind of government program, assets limits are regularly adjusted or eliminated. If enough people join their voices, maybe someone will make the program more 21st Century.
Donate. Yes, cans of food and other non-perishables are great but if you can swing it send them money. My local food bank says they can provide two meals for every dollar donated, a can of soup costs more than that so it’s a pretty good deal. I’m lucky that they also operate a farm and a repack location so people in my area are being offered organic, fresh food.
Share seeds. You can grow tomatoes, basil, bush beans and the like just about anywhere. There are videos online for growing crops in an apartment window, apartment terrace or just about any corner of the world. Gardeners know that most packages of seed have more than a single person
wants to grow...I’m looking at you, packages of 20 seeds of zucchini. By sharing, someone may get the bug and start a way to grow their own fresh food. A very inexpensive package of seeds can be bought for as little as twenty-five cents at the local dollar store and there are hundreds if not thousands of online videos showing how to use food scraps to grow more food. Free seeds are just a seed bank away and usually can be accessed at your local library.
Promote programs like SNAP but also Meals on Wheels, and Congregate or Dining Room Meals (also called Senior Center Meals). Improve programs that support financial well-being.
Create more affordable housing. If people aren't spending their last cent in order to live off the streets, they can begin to spend money on the luxury item of food.
What we know is that the problem won’t resolve itself. Ignoring it hasn’t helped. Globally, locally, we have to make a commitment that people, all people, deserve healthy, nutritious meals.
By Mary Coupland
Owning a pet today, whether it’s a dog or cat, often involves treating them as part of the family. Here’s a look at current trends and aspects related to pet ownership.
Pets these days are just like us. They get birthday cakes, day care and rubber boots to wear in the snow.
Pet ownership has evolved to include a wide array of products and services. Pets are often seen as family members, so owners frequently invest in high-quality food, toys, grooming products, and even clothing. There’s a growing market for luxury and specialty items tailored to pets, similar to how parents might shop for their children.
When it comes to healthcare expenses for pets these have indeed been on the rise. Their health care is becoming more human — for better and for worse. Veterinary care can be costly, especially for treatments like surgeries, diagnostics, and long-term medications. Routine checkups, vaccinations, and dental care also contribute to the overall expenses. This has led to the increasing popularity
of pet insurance as a way to manage unexpected veterinary costs.
Pet Insurance has become more prevalent and offers varying levels of coverage for accidents, illnesses, and sometimes routine care. It helps pet owners manage the financial burden of veterinary bills and ensures that their pets can receive necessary medical treatment without financial strain. And if Pet Insurance isn’t right for you, ask your veterinary office about other financial programs to help you pay your vet bill, such as Care Credit, Scratch Pay, and other options available in your local community,
The veterinary field has seen changes as well. Many independent veterinary practices have joined larger corporate groups or networks. This shift can provide access to more resources, advanced technology, and specialized services. However, it has also sparked discussions about the impact on personalized care and the veterinarian-client relationship.
How does all of this affect those families on a fixed income that want to have that furry four-legged family member? While affording a pet can be challenging for low-income
families due to the cost of food, healthcare, and other essentials, there are various organizations and programs who aim to make pet ownership more accessible. Some veterinary clinics offer discounted services for low-income families, and there are community initiatives providing subsidized pet food and basic care. Your local Humane Society can be a wealth of information connecting you with these resources.
I recently read an article in the Seattle Times about Doney Coe, a Pet Clinic in the Seattle WA area. They were the first no-cost veterinary clinic for homeless and low-income families. They believe all animals deserve to be healthy and loved. After years in temporary spaces, they now have a permanent space, and folks line up for services. Visit their website to learn more about this non-profit organization with a big heart at https://doneycoe.org/.
Owning a pet can bring many benefits to senior couples or single seniors, but it also comes with its challenges. If you’re a senior on a fixed income don’t discount pet ownership. The benefits and community resources can help make this a win-win for you and your pet. Let’s take a moment to examine the pros and cons in order to help you and your loved ones navigate a healthy pet ownership.
Pros for Owning a Pet:
Companionship and Emotional Support - Pets provide companionship, which can help alleviate loneliness and provide emotional support, especially for seniors living alone. Interacting with a pet can reduce stress, anxiety, and depression, promoting overall mental well-being.
Routine and Activity - Pets require regular care and daily routines, which can give seniors a sense of purpose and structure to their day. Walking a dog or playing with a pet can encourage physical activity and help seniors stay active and engaged.
Social Interaction - Pets can facilitate social interactions with neighbors, other pet owners, or during visits to the veterinarian or pet stores. This social engagement is beneficial for seniors, helping them stay connected and involved in their community.
Health Benefits - Studies suggest that pet ownership can lower blood pressure, reduce the risk of heart disease, and improve overall physical health. The companionship of a pet may also contribute to faster recovery from illnesses and a stronger immune system.
Sense of Purpose and Responsibility - Caring for a pet gives seniors a sense of responsibility and accomplishment, boosting self-esteem and mental agility.
Cons to review when considering pet ownership, and how to make owning a pet a reality:
Financial Costs - Pets can be expensive to care for, especially in terms of veterinary bills, food, grooming, and other supplies. On a fixed income, seniors may find it challenging to afford these ongoing expenses. Do your local research to see what financial assistance and other programs are out there to help you make this a reality.
Physical Demands - Some pets, like dogs, require regular exercise and may need to be walked multiple times a day, which can be physically demanding for seniors with mobility issues. Grooming and cleaning up after pets can also be physically taxing.
Potential Health Risks - Seniors may be more susceptible to injuries from falls or strains while caring for pets, especially larger or more active animals. Pet allergies or zoonotic diseases (diseases that can be transmitted from animals to humans) are also concerns.
Travel and Lifestyle Changes - Owning a pet can limit travel options. Pets require consistent care and attention, which may conflict with a senior’s desire for spontaneity or flexibility in their schedule.
Long-term Commitment - Pets can live for years, even decades, and seniors need to consider whether they are prepared for the long-term commitment and potential care needs as the pet ages.
While pet ownership today involves significant expenditures on products and healthcare, there are also options like pet insurance and community support to help manage costs. For senior couples or singles it’s essential to carefully consider the financial, physical, and lifestyle implications when considering a pet. For those who are able and willing to commit to the responsibilities of pet ownership, the benefits of companionship, routine, and improved well-being can be significant.
Do your homework and see what’s best for you and your family, because having a four-legged furry family member can be priceless.
By Beth Pratt
Istarted life in 1974, firmly in the camp of Daddy’s Girl. My father was working to support our family and finishing his bachelor’s degree when I was born, but he always spent time with me. He read to me, played games with me, carried me around on his shoulders. Big surprise, my first word was Dada.
Of course, the normal ups and downs of teenage rebellion, young adult growth away from home, and some philosophical differences gave us the standard-issue bumps in the road, but I was always a Daddy’s Girl. And, while he never has loved that I now live about 5 hours north of their home, he is proud of me and the work I get to do in my adopted hometown.
Dad is sort of retired now, running a vintage Husqvarna motorcycle business, keeping as active as always at 76 years old. In 2022, he found the deterioration of his knees increasingly difficult to manage with injections and braces and ice. The time had come for replacements.
He had surgery in the summer of 2023, with great results on his first knee. His second knee was scheduled for 8 months later. His physical therapy went well, his strength built back quickly, and always full of humor, his mood was
excellent. The pain was gone in that knee.
Then he had a blood clot. Not a big deal, but it was a bit of a setback. He had to pause his therapy, take blood thinners and report to his physician regularly. But it resolved, and therapy continued.
But his energy seemed sapped after this event. His knee was fine, in fact a perfect example of a good replacement installation. His doctor reminded him, he had just had major surgery, followed by the blood clot. Of course he was feeling fatigued. Give it time.
It was not post-operative fatigue, though. The surgery had opened the door for his as-yet-undetected lung cancer. Now at Stage 4, metastasized throughout his body, with tumors appearing in organs, bones, and his neurological system. As a family, we found out over Thanksgiving Weekend.
It looked dire. He was losing weight rapidly, developed a constant cough, and edema was impacting his chest cavity and his joints. Would he decline so far before treatment options were identified that treatment would be moot? Would there be a treatment less awful than full-blown chemotherapy? What would he and Mom decide was best?
And how was this Daddy’s Girl supposed to process, far too quickly, the mortality and impending awfulness of cancer and cancer treatment? Sobbing in the shower was perhaps a reasonable reaction, if not particularly helpful.
Besides, what in the world could I do to help? I am too far away, and full-time employed, to be a taxi service, cook or household helper. My Mom is quite capable of managing their household, she is the best homemaker ever to make a home in my opinion.
But I wanted to be there, be with my parents, my brother, all of my family (and there are a lot of us).
I made extra weekend trips just to be present. To take Mom out to shop for an hour, to visit with Dad about a book we both love or a development with the James Webb Telescope. To spend time with them both. For almost 20 years, I have made a point to be present for major holidays and visit about 6 times a year. Between the first of
November and the first of January, I was there four times. One thing I could try to help with was Dad’s appetite and weight loss. I found a marijuana dispensary with an RN and a pharmacist on staff and scheduled an appointment. She helped me find some tools and resources to suggest to Dad, and some for me. In moments like this, you take whatever help you can find.
It was on December 20th that we learned he would have medication therapies available to him. His course of treatment began in early January. It took weeks before the medication demonstrated its impact. He had some blood work results that halted treatment on a couple of occasions. But, through those first months, my parents were a diligent team, taking appointments with patient navigators, consultants, the oncologist, the orthopedist.
And Dad started to improve.
By June of 2024, he had seen such dramatic impacts from his therapies, his oncologist graduated him from monthly scans and meetings to quarterly appointments. His tumors were shrinking, his edema was better managed, his overall health was improved.
Dad still has Stage 4 Lung Cancer, but now it has slowed it down, and we have some time. You never know how much time, with or without cancer. But right now, we are going to take the win.
But what about this Daddy’s Girl? It took me a couple of months to get the dread, depression and anxiety under control. I asked my husband to take up extra household tasks, my brain was too full to manage it. I prepared to jump to Oregon at any time, working on contingency plans should I need to work remotely. And I set aside all travel plans, saving my PTO for when I may be needed.
But mostly, I tuned in to my parents with more closeness than normal – and that is saying something. My Mom is my best forever friend, and
we talk and text regularly. But now I make a point of calling when I think I’ll catch them both, so we can all visit over breakfast or lunch. I found non-holiday reasons to pack up and head south to visit. And I made myself available for any family member who wanted to ask questions but didn’t want to bother Mom with one more call.
We of Generation X are in the Squeeze: caught between aging parents, our own needs, and the needs of our children (should we have them), our jobs and our households. I am one of the lucky ones, my parents have means to care for themselves, my brother is close by, as are all 8 of my nieces and nephews. Without children of my own, my personal Squeeze is not so bad. My heart breaks for families without the means to pay for care, for children so estranged that both they and their parents are left alone. Our family has a lot going right, even as we face something going terribly wrong.
For now, with a positive prognosis and time to spend together, our tight-knit family is staying in close contact. The folks keep me up to date on their news as well as all their grandchildren. I tell them tales of being a Chamber of Commerce director in a small town. And I’m looking at hotel rates over the coming weeks to schedule a visitbetween-holiday weekends soon.
Beth Pratt, Executive Director, Sequim-Dungeness Valley Chamber of Commerce and Visitor Information Center, 360683-6197, https://www.sequimchamber.com/
By Sue-Marie Casagrande, LICSW, C-ASWCM
When I first met Vivian, she was staying in a shared room in one of our local skilled nursing facilities, having converted to custodial status, which means the skilled nursing facility was planning on keeping her there to live full-time.
Many steps needed to be taken for Vivian to return home, including signing up with a private caregiving agency for daily caregivers to help with personal and household care. To cover the cost of private caregivers while waiting for her long-term care policy’s elimination period to transpire, Vivian also took out a reverse mortgage on her home. Once Vivian met her 90-day elimination period, she had a monthly budget of up to $7,500 with which to cover the cost of private caregiving. At the time, this equated to several hours per month—not anywhere close to 24/7, but enough that she and her spouse received help with housekeeping, meal preparation, grocery shopping, and pet care, in addition to help with activities of daily living.
Vivian’s spouse passed away 18 months after she returned home from the skilled nursing facility. She did okay on her own, but the home was too big, and it soon became clear she would need more assistance in caring for herself than her long-term care policy would cover.
Vivian also began working with my friend Deb Hurd, who assisted her in downsizing and eventually putting her home on the market with a plan to move into assisted living at Brookdale Montclair in Poulsbo.
As often happens, Vivian moved a couple times until she found the right apartment for her, which was on the top level of Brookdale Montclair overlooking the Olympic Mountains.
Vivian encountered the same challenges all of us encountered when COVID came around. She also experienced a lot of increased anxiety during COVID, especially after her primary care physician abruptly left his practice and we had to find a new primary care physician for her.
Vivian did quite well at Brookdale. It wasn’t always easy for Vivian to have to rely so much on others for her care. Sometimes she became frustrated with certain aspects of her care but wasn’t usually sure how to identify and communicate her needs to staff. She would complain to me, I would listen, paraphrase what I thought was happening for clarity, and determine how best to get her needs and wants met based on her current wishes and available resources.
I became and remained Vivian’s advocate and point person for coordinating all her care throughout her multiple moves, the loss of her husband and cat, the COVID pandemic, and the challenges of growing old in a fragmented world. We talked on the phone daily, especially throughout the worst of the pandemic when Vivian started having panic attacks. I was able to talk her down over the phone, not being able to visit her in person. Vivian, Deb and I worked as a team to do as much as we could do to make things better for Miss V, as some caregivers preferred to call her.
I brought Vivian to her medical appointments and helped coordinate her care so that all her providers knew what was happening with her, not just with her heart, or her lungs, her eyes or her teeth, but with Vivian as an individual with unique needs and concerns that affected all of her health and wellbeing—just like all of us.
As I continued to support Vivian medically and work with
her emotionally, I became aware of her fear of death. Eventually, when she was ready, both Deb and I started working with Vivian on her personal values and feelings about end-of-life. While I prepared her emotionally and mentally, Deb worked with Vivian to put together all her end of life wishes regarding her choice of funeral homes, how she would want her end-of-life celebration to go, who would conduct the service at her church, what would happen to her remains. These plans were well established many months before her passing and I believe it gave her comfort to have an idea of how things would go once she was gone.
In the last 18 months or so of her life, Vivian began contracting pneumonia, as she’d had compromised lungs for most of her life due to tuberculosis exposure. Her physician was excellent at prescribing the right medication, and if we caught it early enough, she could avoid a hospitalization for IV antibiotics.
As her lungs continued to give her trouble and her fatigue increased, her strength decreased, and her emotions grew weary, we talked about palliative care or hospice care as two options for receiving care without having to go back to the hospital anymore. If she chose palliative care, I explained, she would still be able to go to the hospital for certain things, but with hospice, the focus is on comfort, and she would need to be discharged from hospice care in order to go to the hospital for curative treatment. After the treatment, she would then be free to enroll in hospice again.
During our last appointment with her physician, he shared that when his patients decide to go onto hospice, they are ultimately saying that they no longer want to go to the hospital. We had already figured out how to get her lungs x-rayed at home when we suspected pneumonia was developing. We were prepared to order home IV antibiotics if necessary. We were also prepared to support her in going into palliative care or hospice, her choice, no questions asked, because this was her life, and it needed to go her way.
One evening Vivian and I were talking about her health, her life, her happiness, and whether she wanted to continue to go to the hospital for curative treatments, go into palliative care and potentially receive IV antibiotics at home if needed, or let nature take its course. She said she wanted to let nature takes its course, and so we enrolled her in hospice with Virginia Mason Franciscan Health’s hospice program the next day.
There were a few bumps during the initiation of hospice. The hospice nurse didn’t want Vivian to take any prophylactic antibiotics to help keep her lungs a
little clearer so that she could breathe more easily. She wanted to prescribe a very strong anti-psychotic to help Vivian sleep, not understanding how sensitive she was to medications and all chemicals. She also wanted to increase Vivian’s anti-depressant dose after her physician had been working for at least a year to slowly raise the dose in tiny increments so she could gradually reach the lowest dose made by the manufacturer.
At that point, I advocated directly with Vivian’s primary care physician (PCP), and he wrote a prescription for prophylactic antibiotics for Vivian as well as orders to maintain her low dose of an anti-depressant. As her PCP, he could override hospice orders as he had the final say in her treatment. This wasn’t necessary though, because the hospice medical director agreed with Vivian’s PCP and let the nurse know prophylactic antibiotics were not curative, and thus acceptable for hospice patients in our area.
Vivian did not want to die alone. She did not want to die in pain. She wanted either me or Deb to be with her and by her side in the end. After seven years of working with Vivian, we both made solemn promises to do just that, and that’s exactly what we did.
I tried to soothe Vivian’s discomfort by purchasing small, washable pillows that we could put in various places to help alleviate pressure. I brought a lavender sachet from the Sequim Lavender Festival for her to smell, since she loved flowers and specifically the lavender festival. I set up her TV on YouTube to show beautiful nature images or flowers and landscapes with soothing music in the background. Staff came to see her and to say goodbye and let her know how much she meant to them. Many of them told her that they loved her.
On the very early morning of October 21, 2023, not long past midnight, Vivian exhaled her last breath and died peacefully on her bed at home with a friend by her side, exactly as she wanted to go.
It was truly an honor and privilege to support Vivian from her time in the skilled nursing facility to her last moments on earth. She was known by everyone as a kind lady because she was a deeply loving compassionate, caring person who loved all the world. We grew to love one another, and I think of her often. I also feel proud of the work I did with her because I know it made a difference and enabled her to live her last years the way she wanted. She was one of a kind, and I will never forget her.
Sue-Marie Casagrande, Owner Care Plans Plus, LICSW, C-ASWCM, Advanced Aging Life Care Professional, 360881-7900, https://www.careplansplus.com/
By Mary Coupland
What is Aging in Place? Aging in Place refers to the ability of older adults to live in their own homes and communities safely, independently, and comfortably, regardless of age, income, or ability level. It implies that older people will remain in the community, either in their family homes, in homes to which they have moved in middle or later life, or in a supported accommodation of some type, rather than moving into residential care. It also implies living independently of other family members.
The Aging in Place trend is growing, reflecting the desires of the aging population to remain in their homes and the increasing availability of resources and technologies to support this lifestyle choice, and it’s driven by several factors:
Preference for Independence: Many older adults prefer to maintain their independence and stay in their homes, where they feel comfortable and have established routines and social connections. My father moved to California to
live near my sister in 2023, and at the young age of 90 he’s enjoying his own independent cottage in a 55+ older community, and doing his own grocery shopping and meal prep.
Economic Considerations: Aging in place can be more cost-effective compared to the high costs associated with assisted living facilities or nursing homes. Many seniors and their families find it financially beneficial to modify existing homes for aging in place.
See the article in this issue by Ted Butler, “Embracing the Sunset, a sunny view of retirement,” speaking about how a modern reverse mtg / HECM can be used for home modifications.
Government and Community Programs: Various programs and initiatives at federal, state, and local levels are being developed to support aging in place. These include grants for home modifications, community-based services, and policies aimed at improving accessibility and safety in the home.
One example of how these home-based support services help seniors remain at home is the Meals on Wheels
organization. One in two seniors living alone lacks the money to pay for basic needs. Meals on Wheels saves US tax dollars by keeping people out of costlier forms of care. They are more than just a meal. Ask them about their other services, and medically tailored meals.
Advancements in Technology: Innovations in smart home technology, telemedicine, and health monitoring devices are making it easier for seniors to live independently while staying safe and connected to caregivers and healthcare providers.
Have you ever heard the saying, “You’re not getting older, you’re getting better?”
I like to think of it as, “We’re not getting older, we’re getting smarter.”
And why wouldn’t we be in this day and age when we have so much technology at our fingertips that our grandparents didn’t have when they were 50+ older.
Embrace technology and AI, let it support you through your senior chapter of life. In 2024, several smart home technologies and health and wellness tech are at the forefront of helping seniors age in place safely and independently. Here are some of the top technologies:
Smart Speakers and Voice Assistants: Devices like Amazon Echo and Google Home allow seniors to control various smart home devices using voice commands, set reminders for medications, and make emergency calls.
Smart Lighting: Automated lighting systems that can be controlled via voice, motion sensors, or smartphone apps. Examples include Philips Hue and the Nobi Smart Lamp, which can also detect falls.
Smart Thermostats: Devices like the Nest Thermostat allow for easy temperature control and can learn the user’s schedule to optimize comfort and energy efficiency.
Smart Security Systems: Security cameras, doorbell cameras (like Ring), and smart locks that can be monitored and controlled remotely to ensure the home’s security.
Automated Medication Dispensers: Devices that dispense medication at scheduled times and alert the user or caregivers if a dose is missed. Examples include MedMinder and Hero.
Wearable Health Monitors & Fall Alert Detection Devices: Devices like smartwatches (Assistance Now, Fitbit, Apple Watch) that track vital signs, activity levels, and can detect falls. Devices like the Nobi Smart Lamp and wearable fall
detectors that alert caregivers or emergency services if a fall is detected. They often include emergency call features. Telehealth Platforms: Services that allow seniors to consult with healthcare providers remotely, reducing the need for in-person visits. Examples include Teladoc and Doctor on Demand. Ask your doctor’s office if they provide Telemedicine Virtual Appointments.
Remote Patient Monitoring Systems: Devices that monitor health conditions such as blood pressure, glucose levels, and heart rate, and transmit data to healthcare providers. Examples include Omron’s remote monitoring solutions and iHealth.
Robotic Assistants: Robots like Jibo and ElliQ that provide companionship, remind users to take medications, and can assist with simple tasks around the home.
Smart Toilets and Bathroom Aids: Toilets with features like automatic flushing, seat warming, and bidet functions, as well as other smart bathroom aids that enhance safety and hygiene. Casana is innovating healthcare delivery with a smart toilet seat that enables effortless, integrated, and accurate in-home health monitoring. The FDA cleared Heart Seat® captures heart rate and blood oxygenation.
Mobility Aids: Smart walkers and wheelchairs equipped with navigation aids, sensors, and connectivity features that help seniors move around safely.
Smart Plugs, Outlets and Appliances: Devices that allow seniors to control appliances remotely, ensuring that devices are turned off when not in use to prevent hazards. Appliances with built-in safety features and connectivity, such as ovens that can be controlled remotely and refrigerators that can monitor food inventory and expiration dates.
Voice-Controlled Windows and Blinds: Systems that allow for easy control of natural light and ventilation without manual effort.
Adjustable Furniture: Beds, chairs, and tables with adjustable heights and positions to enhance comfort and accessibility. Lift Chairs that the seat and back lift up to help you into a standing position.
These technologies collectively enhance safety, independence, and quality of life for seniors aging in place by addressing their unique needs and providing seamless integration into their daily routines.
Todd Tidball
Edward Jones
Poulsbo
Aaron Steele
Steele Capital Management
Western WA
Brent Tayet
Edward Jones
Gig Harbor
Kimberlie Olsen
Edward Jones Gig Harbor
Cook Family Funeral Home & Cremation Services
(Please see our ad on page 8)
163 Wyatt Way NE
Bainbridge Island (206) 842-2642
https://www.cookfamilyfuneralhome.com/
Kosec Funeral Home & Cremations Services
Port Townsend
We Know Medicare
(Please see our ad on page 39)
Serving Clallam & Je erson County (360) 633-7626
https://weknowmedicare.org/gary- oring/
Reetz Insurance
Port Angeles
Regence BlueShield
Clallam, Je erson, King, Kitsap, Mason and Pierce Counties
Hillcrest Cemetery
(Please see our ad on page 8)
Old Mill Road NE
Bainbridge Island (206)842-2642
Haven of Rest Funeral Home Gig Harbor
Farmers Insurance - ompson Agency
Port Orchard
Paula Weissinger NMLS ID #1875429
State Farm Agent & Quicken Loans Rocket
Mortgage Professional
Serving Kitsap County & Surrounding Area (206) 855-0855 phone, (206) 201-3865 fax
Je erson County JC Madison Inc
KMi Insurance
Port Townsend
Long Term Financial Allyn
Clean Lines Fashion Consulting
Lisa Kemmerling
(see our ad on page 40)
Serving the United States and Canada (925) 719-2314
www.cleanlinesfashion.com
Poulsbo (360) 779-1082
https://www.jcmadisoninc.com/
Image consultants aim to improve the image of their customers professionally or personally and are generally experts in marketing and fashion.
Suseyi Pro Moving Company
Residential | Commercial
(see our ad on page 32)
Serving Kitsap, King and Surrounding Counties (206) 372-4619
www.kitsapmovers.com
Homestead Move & Estate Services
(see our ad on page 21)
Serving Pierce, Kitsap, and King Counties (253) 906-9696
www.homesteadmove.com
Sound Equity Investments, LLC
Serving Kitsap, King and Surrounding Counties
Kummerow Design & Construction, Inc.
(see our ad on page 30)
Serving Bainbridge Island & the Surrounding Area
(206) 201-3602
www.kdcdesignbuild.com
Clallam County
Brokers Group Real Estate Professionals
Kitsap County Kitsap County
Sequim Clark Construction Bainbridge Island Je rey B. Miller, SRES, SRS, e-Pro, PSA | Broker/Realtor
RE/MAX Elite Serving the Puget Sound Region
Kitsap Seniors Real Estate-Teri Tennyson-Sterling Property Group Silverdale
Mutual of Omaha, Ted Butler
Lifestyle Home Loan Specialist, NMLS #71436(see our ad on page 10)
Ph: (425) 889-8989 | Cell: (425) 891-6644
Serving WA, CA, AZ, ID, OR https://mutualreverse.com/lo/ted-butler/
Kitsap County Kitsap County Pierce County
Fairway Mortgage, Joan Qvigstad Serving the Puget Sound Region
Cornerstone Home Lending Poulsbo
Longbridge Financial, Rebecca Rainsberger Covering WA state (253) 509-2340
https://agents.longbridge- nancial.com/ rebecca-rainsberger
Kitsap County
Easter Seals Adult Day Services
Bremerton
WA State Nationwide
National Aging in Place CouncilWA Chapter
Rebecca Rainsberger
President Chair / Founder
https://ageinplace.org/
NAIPC (National Aging in Place Council)
https://ageinplace.org/
e U.S. Centers for Disease Control and Prevention de nes aging in place as "the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level" e NAIPC is a senior support network that connects service providers with older adults, their families, and caretakers, across the U.S.
Life Flight Network
Serving the Paci c Northwest Communications Center 24/7 (800) 232-0911 or (208) 367-3114
Alzheimer’s Association
(Please see our ad on page 24 & 25)
WA State Chapter (800) 272-3900
https://www.alz.org/alzwa
American Cancer Society (800) 729-3880
American Lung Association (800) 586-4872
AWAKE - Apnea Support (360) 792-6686
Bereavement, Hospice Support Group (360) 415-6911
Brain Injury Support (360) 475-6480
Breast Cancer Support (360) 792-6885
Kitsap Caregiver Support Center
Givens Community Center - 1026 Sidney Ave. Suite 105, Port Orchard
NK Fishline, 19705 Viking Ave NW, Poulsbo (360) 337-5700/(800) 562-6418
Diabetes Support (888) 342-2383
DriveAble (253) 851-0007
Hepatitis Support Person (360) 876-3837
Lung Club Support (360) 792-6686
National Alliance for the Mentally Ill (NAMI) (360) 377-2910
NK Breast Cancer Support Group (206)-842-6218
Ostomy Support Group (360) 692-3869
Ovarian Cancer Support Group (360) 697-6123
Parkinson’s Support Group (360) 475-6480
Rock Steady Boxing for Parkinson's (888) 217-0577
Self Help for Hard of Hearing People (SHHH) (360) 871-0997
Stroke Support Group (360) 337-8980
Care Plans Plus
Serving the Olympic Peninsula (see our ad on page 50) (360) 881-7900
https://www.careplansplus.com/
Alder
New Season Move Management
Serving Je erson County and Surrounding Areas
(please see our ad on page 29) Port Hadlock (360) 774-1255
https://www.newseasonmove.com/
(see our ad on page 21) Serving Pierce, Kitsap and King Counties (253) 906-9696 www.homesteadmove.com/ A
Specialist is a designation used to identify those individuals trained to help seniors and older adults live safely in their homes.
Caring Transitions Olympic
Serving Clallam & Je erson
Silver Bridge Senior Transitions, Jim
Pinnacle Senior Placements, Daphne Davis
(Please see our ad on page 22)
Serving Western WA (206) 375-4002
https://pinnacleseniorplacements.com/
(Please
(Please see our ad on page 23)
834 Sheridan Street, 2nd Flr, ESSB (360) 344-1001
Sheridan Street, 2nd Flr, ESSB (360) 344-0400
Olympic Pharmacy & Healthcare Services
(Please see our ad on page 15)
Serving Gig Harbor and surrounding areas
Available for mail orders (253)858-9941
https://www.olympicpharmacy.com/
Bellevue HealthCare
Sequim
Lincare Port Angeles
Olympic Oxygen Services Sequim
Assistance Now
(Please see our ad on page 17) e all new Mobli by Assistance Now Wearable Watch Fall Detection, Alerts, Monitoring, and Custom APP (888) 877-7562
https://assistancenow.com/
Bellevue HealthCare Bremerton
Lincare Bremerton
Performance Home Medical Bremerton & Silverdale Tim’s Home Medical Supplies Bremerton
NOBI Smart Lamp Ensuring older adults can live more independently https://www.nobi.life/en
Assured Hospice
(Please see our ad on page 20)
Serving Je erson & Clallam Counties
Port Angeles (360) 582-3796
https://lhcgroup.com/locations/assuredhospice-of-port-angeles/
CHI Franciscan Family Medicine Clinic
4207 Kitsap Way
Bremerton (360) 782-5700
Franciscan Urgent Care
1344 Wintergreen Lane, Suite #100
Bainbridge Island (206) 201-0488
St. Anthony's Hospital 11567 Canterwood Blvd NW Gig Harbor (253) 530-2000
St. Michael Medical Center 1800 NW Myhre Rd.
Silverdale (360) 337-8800 US Naval
St. Michael Medical Center 2520 Cherry Ave
Bremerton (360) 744-3911
Bremerton (360) 475-4000
Virginia Mason Medical Center 1344 Wintergreen Lane NE
Bainbridge Island (206) 842-5632
(Please
Clallam Kitsap
NW Eye Surgeons
Sequim
Paci c EyeCare
Port Townsend
Achieve Eye & Laser Specialists Silverdale
Island Family Eyecare Bainbridge Island
Kitsap Eye Physicians Bremerton & Port Orchard
Paci c EyeCare Poulsbo
Silverdale Eye Physicians Silverdale
Summit Eye Consultants
Bainbridge Island
20/20 Eyecare Centers
Auburn, Kingston, Milton, Port Orchard, Silverdale & Vashon Island
Paci c Northwest Eye Associates Gig Harbor
EyeCandy Optical Gig Harbor
Olympic Pharmacy & Healthcare Services
(Please see our ad on page 15)
Serving Gig Harbor & Surrounding Areas
Available for mail orders (253) 858-9941 https://www.olympicpharmacy.com/
Cost Co Pharmacy Sequim
Jim’s Pharmacy
Port Angeles
Je erson County
Don’s Pharmacy
Port Townsend
Tri-Area Pharmacy
Port Hadlock
Cascade Specialty Pharmacy Poulsbo
Cost Co Pharmacy Silverdale
Costless Senior Services
Serving Clallam, Je erson, Kitsap, Mason & Pierce Counties
Cost Co Pharmacy Gig Harbor
Geneva Woods (delivery pharmacy) Serving the WestSound Region
Je erson Healthcare Physical erapy & Rehabilitation
(Please see our ad on page 23)
834 Sheridan St., Main Flr ESSB Port Townsend (360) 385-2200, ext 1200
Olympic Medical Rehabilitation, Physical & Occupational erapy
Port Angeles & Sequim
Peninsula Speech erapy Port Townsend
Bainbridge Island Health & Rehabilitation Center
Bainbridge Island
Bremerton Health & Rehabilitation
Bremerton
Harbor Speech Pathology Port Orchard
Kitsap Physical erapy
7 Locations throughout Kitsap
Martha & Mary Health and Rehab Center Poulsbo
Northwoods Lodge Silverdale
Wade Zinn Physical erapy Poulsbo
Your Forever Home Serving Kitsap County & Surrounding Areas
Harbor Speech Pathology & Driveable (Cognitive drivers assessments) Gig Harbor
Meals on Wheels-Kitsap
(Please see our ads on page 45)
Serving Kitsap County (360) 377-8511 / (888) 877-8511
Clallam County
Sequim Food bank
144 W. Alder St (360) 683-1205
Port Angeles Food Bank 402 S. Valley St. (360) 452-8568
Bremerton Food Line 1600 12th St (360) 479-6188
Central Kitsap Food Bank (Silverdale) 3537 NW Anderson Hill Rd (360) 692-9818
Meals on Wheels Kitsap has been the major provider of nutrition services for elderly persons aged 60 years and older in Kitsap County since 1973. eir target population are frail, lowincome elderly persons who depend on well-balanced meals for their primary source of nutrition, as food is a basic need. http://www.mealsonwheelskitsap.org/
Helpline House Food Bank (Bainbridge) 282 Knechtel Way NE (206) 842-7621
North Kitsap Fishline (Poulsbo) 19705 Viking Ave NW (360) 779-5190
Share Net Food Bank 26061 United Rd NE (360) 297-2266 Serving Eglon, Hansville, Kingston, Suquamish
South Kitsap Helpline (Port Orchard) 1012 Mitchell Ave (360) 876-4089
erson County
Port Townsend Food Bank 1925 Blaine St (360) 531-0275
Tri Area Food Bank 760 Chimacum Rd Chimacum (360) 385-9462
Brinnon Food Bank 151 Corey St (360) 796-4444
Quilcene Food Bank 29452 US-101 (360) 785-0904
Gig Harbor Peninsula Fish 4425 Burnham Dr (253) 858-6179
Staff & Residence
First impressions are important. Before anything else happens, check your instincts when you first walk in the door. Does the community smell clean? How often is housekeeping provided in personal living spaces? Here are some additional details to take into account:
Visitors receive warm greeting at entrance
Staff know residents and call them by name
Residents appear happy and are well groomed
What kind of training does staff receive
Dining
Are visits with residents welcome at any time
Can the staff provide the appropriate support
What is the staff-to-resident ratio
Is there an outside area for residents
Nutrition is an important part of remaining strong and healthy at any age but it is especially important as we age. Regular, nutritious meals help prevent behavioral problems for those with cognitive health issues as well.
Are snacks available during the day
Is there assistance with eating if needed
Can family members eat in the dining area
Meals are nutritious and appealing
Transportation
Can the kitchen provide special meals for those with special dietary needs
What options are available for a resident that can’t make it to the dining room
Boredom is a surefire way to make living in a senior residence or anywhere a trial. With 1,440 minutes in a day, not having work, time spent on maintaining a residence, or other activities to engage in can cause the day to weigh heavily. Activities are at least as important as meals.
Activities
Is transportation available for local shopping and health care
How often are trips available
Are there religious activities available
Are activities well attended
Do activities match interest
Do activities vary
Building codes provide some security for residents but any residence worth its salt needs to go beyond the bare essentials. Here are just a few areas to consider.
Does the residence perform an initial assessment prior to admission
Are grab bars available in bathrooms and halls
What kind of safety features are available if a resident has a health crisis
Who is available at night in an emergency
Some senior residences require government oversight. If the type of residence you are considering is a nursing home, an Adult Family Home, or assisted living facilities, you can find scores for those facilities on the Department of Social and Health Services (DSHS) as well as additional information about other senior residences at https://www.dshs.wa.gov/altsa/residential-care-services/long-term-care-residential-options .
408 W. Washington St
(360) 207-4896
Oak Drive
(360) 582-9309
JEFFERSON COUNTY
SAN JUAN VILLA (Caring Places)
112 Castellano Way PORT TOWNSEND (360) 344-3114
Avamere at Port Townsend PORT TOWNSEND
Victoria Place PORT
THE ARBOR ASSISTED LIVING
(Care Partners Senior Living) 3500 9th St
BREMERTON (360) 479-4130
THE ARBOR MEMORY CARE
(Care Partners Senior Living) 3510 9th St.
BREMERTON (360) 525-9000
LIBERTY SHORES/HARBOR HOUSE
(Northwest Care Senior Living) 19360 Viking Way NW POULSBO (360) 779-5533
MADISON AVE HOUSE
(Bainbridge Senior Living) 285 Madison Ave S BAINBRIDGE ISLAND (206) 842-3694
MADRONA HOUSE
(Bainbridge Senior Living) 8800 Madison Ave N. BAINBRIDGE ISLAND (206) 317-6000
VINEYARD PARK OF BREMERTON (Care Partners Senior LIving) 2707 Clare Ave BREMERTON (562) 232-2695
WINSLOW
(Bainbridge Senior Living) 234 Wood Ave SW BAINBRIDGE ISLAND (206) 842-3694
(Bainbridge
(208)
KING COUNTY
FAIRFIELD - 14 Locations
I-5 Corridor
OLYMPIA TO BELLINGHAM (858) 457-2123
https://www.fair eldresidential. com/
ROSEWOOD COURTE MEMORY CARE
(Northwest Care Senior Living)
728 Edmonds Way EDMONDS (425) 673-2875
MASON COUNTY
Haven In Allyn
PIERCE COUNTY
Family
Gig Harbor Court (Pegasus Senior Living)
GIG HARBOR
Harbor Place
Cottesmore Campus
GIG HARBOR
Heron’s Key & Penrose Harbor
Kensington Gardens GIG
Olympic
GIG
Certi ed Professional Guardians (CPG’s are appointed by the Courts to protect, advocate for, and serve the interests of disabled and vulnerable adults.)
Bridge Builders
Sequim Caring Choices
Elaine Morgan & Kathleen Traci Port Ludlow
Tony Hinson
Sherrard McGonagle Tizzano & Lind
(Please see our ad on page 35)
19717 Front Street NE
Poulsbo (360) 779-5551
https://www.sherrardlaw.com/
Hayes Gori, PLLC
Bainbridge Island
Richmond & Richmond Port Orchard
Sanchez, Mitchell, Eastman & Cure Bremerton
Pro ducia
(Please see our ad on page 45)
Serving the Puget Sound & Surrounding Area
(206) 573-5276
www.pro ducia.com
Heidi Abrams
Sherrard McGonagle Tizzano & Lind
19717 Front Street NE
Poulsbo (360) 779-5551
https://www.sherrardlaw.com/
Matt Lind
Sherrard McGonagle Tizzano & Lind
19717 Front Street NE
Poulsbo (360) 779-5551
https://www.sherrardlaw.com/
David Faber, Faber Feinson PLLC Port Townsend Law O ces of Bryana Cross Bean Gig Harbor
Mason County
Rick Biehl Law Allyn
(Executor/PR, POA, Trustee, Family CFO & More)
Colleen E. Mriglot
Sherrard McGonagle Tizzano & Lind
(Please see our ad on page 37)
240 Madison Ave North Bainbridge Island (206) 842-5681
https://www.sherrardlaw.com/
William S. McGonagle
Sherrard McGonagle Tizzano & Lind
240 Madison Ave North Bainbridge Island (206) 842-5681
https://www.sherrardlaw.com/
Shows and Entertainment. Find who’s playing in your neighborhood and embrace the local and national artists this year.
https://www.olympicjazz.com/ https://jffa.org/festival/ https://www.olympictheatrearts.org/ https://www.porttownsendvineyards.com/ https://7cedars.com/events/ https://littlecreek.com/event-center/
https://www.thepointcasinoandhotel.com/entertainment/ https://www.clearwatercasino.com/whats-happening/ https://www.admiraltheatre.org/ https://www.roxybremerton.org/ https://www.bremertonwestsoundsymphony.org/ https://www.narrowsmusicsociety.org/ https://www.facebook.com/groups/132224656953154 https://biparks.org/special-events/ https://www.biartmuseum.org/calendar-events/ https://biparks.org/special-events/ https://www.biartmuseum.org/calendar-events/
Sequim-Dungeness Valley Chamber of Commerce, and Visitor Center
1192 E Washington St, Sequim (360) 683-6197 www.sequimchamber.com
Cruise Planners
Your Land & Cruise Experts Serving Clallam, Je erson, King, Kitsap, Mason & Pierce Counties
North Olympic Library System (NOLS) Forks, Port Angeles, Sequim & Clallam Bay Branch
Olympic eatre Arts Sequim
Pedego Electric Bikes Sequim
Port Angeles Community Players Port Angeles
KSQM FM 91.5 www.ksqmfm.com
Sequim (360) 681-0000
Sequim Wheelers Sequim
erson County Library Port Hadlock & Book Mobile
Key City Public eatre Port Townsend
Kitsap County BIMA (Bainbridge Island Museum of Art)
Bainbridge Island
Songwriting Works Port Townsend
Port Angeles Symphony Port Angeles Port Ludlow Marina Port Ludlow
Bainbridge Island Senior Center
370 Brien Ave, SE
Bainbridge Island (206) 842-1616
Bremerton Senior Center 1140 Nipsic Ave
Bremerton (360) 478-5357
Gig Harbor Senior Center 6509 38th Ave NW
Gig Harbor (253) 514-6338 ex 107
Givens Senior Center 1026 Sidney Ave
Port Orchard (360) 337-5743
e HUB
111 NE Old Belfair Hwy
Belfair (360) 275-0535
e Fireside Restaurant Port Ludlow
Admiral eatre Bremerton
BPA (Bainbridge Performing Arts) Bainbridge Island
Clipper Vacations Seattle
Kitsap Regional Library
Bainbridge, Bremerton, Kingston, Little Boston, Manchester, Port Orchard, Poulsbo, Silverdale, Sylvan Way
BIMA (Bainbridge Island Museum of Art) Bainbridge island
Key Peninsula Comm. Svs. 17015 9th St. KPN
Lakebay (253) 884-4440
North Kitsap Sr. Citizens Ctr. 18972 Front St. NE
Poulsbo (360) 779-5702
Port Angeles Senior Center 328 E 7th Street
Port Angeles (360) 457-7004
Port Gamble S’Kallam Sr. Ctr.
Little Boston Road
Kingston (360) 297-4858
Port Townsend Senior Center 620 Tyler St.
Port Townsend (360) 385-9007
Quilcene Community Center 294952 US-101
Quilcene (360) 765-3321
Shipley Center 921 E Hammond St
Sequim (360) 683-6806
Tri-Area Community Center 10 W Valley Rd.
Chimacum (360) 732-4822
Village Green Community Center 26159 Dulay Rd NE
Kingston (360) 297-1263
Bainbridge Island Pickleball http://bipickleball.org
Bremerton Parks & RecreationPickleball (360) 473-5427
Cabin Fever Quilt Club http://cabinfeverquilters.org/
Kitsap Computing Seniors (360) 297-2485
Kitsap Senior Singles (360) 373-8742
Kitsap Quilters https://kitsapquilters.com/
North Mason Senior Club (360) 275-6246
Over the Hill Hikers ( 815) 677-3903
Port Angeles Garden Club http://www.portangelesgardenclub.org/ gardenresources. html
Puget Sound Senior Citizens Club (360) 674-2159/ (360) 377-5905
Sequim Picklers www.sequimpicklers.net
Sequim Prairie Garden Club http://www.sequimprairiegardenclub.org/
Sequim Senior So ball (360) 681-2587
Sunbonnet Sue Quilt Club https://www.sunbonnetsuequiltclub.org/
Trek, Active Senior Excursions (253) 851-8450
West Sound Cycling Club https://www.facebook.com/groups/53775536887/ about/
West Sound Quilters http://www.westsoundquilters.org/
County
Olympic Area on Aging 609 W. Washington St. Ste 16 Sequim (360) 452-3221
Olympic Area on Aging
W. Sims Way, Suite 300
Townsend (360) 385-2552
Olympic Area on Aging 11700 Rhody Drive Port Hadlock (360) 379-5064
Clallam & Je erson County Long Term Care Ombudsman (360) 417-8556
Dove House Advocacy Services Port Townsend (360) 385-5291
Dementia Specialist-Denise Hughes (360) 337-5700 /(800) 562-6418
Kitsap County Senior Information & Assistance Pierce County Long Term Care Ombudsman (253) 798-3789
Kitsap County Long Term Care Ombudsman (360) 337-5714 / (800) 562-6418
Paci c Creative Studios
Amber Wheeler, Marketing Maven Port Angeles, Serving Western WA
Around the Sound
Kitsap County & Olympic Peninsula (360) 874-0055/(253) 858-7088
Clallam Para Transit (360) 451-4511, option 1
Haselwood Auto Group West Hills Auto Plex, Bremerton www.westhillsautoplex.com
Je erson County Human Services Elderly/Disabled Van 10 local communities (360) 674-8104
Kitsap Access (800) 501-7433
e Personal Touch Serving Kitsap, Je erson, Pierce & Mason Counties (360) 895-3980
AMVETS
5717 South Tyler Street
Tacoma (253) 472-2552
Federal Way Vet Center 32020 32nd Ave South Suite 110 Federal Way (253) 838-3090
Homeless Veterans Reintegration Project
Puget Sound Region (800) 562-2308
Tahoma National Cemetery 18600 Southeast 240th St. Kent (425) 413-9614
American Academy of Bene t Planners, Aaron Steele Serving the WestSound (360) 464-2979
Veterans of Foreign Wars 416 Burnett Ave S. Renton (425) 255-9010
Olympic eatre Arts
Veterans Estate Management Program Puget Sound Region (800) 562-2308
WA Department of Veterans A airs (800) 562-0132
WA Veterans Home Retsil 1141 Beach Dr. E. Port Orchard (360) 895-4700 (877) 838-7787
https://olympictheatrearts.org/OTA/?page_ id=559
RSVP, e Retired & Seniors Volunteer Program (360) 452-4726
Serenity Acres Horse Rescue
Sequim Beautiful Day https://sequimbeautifulday.org
RSVP, e Retired & Seniors Volunteer Program (360) 385-2571
WAG (Welfare for Animals Guild) https://wagsequimwa.com/
Abraham's House Charity (360) 405-0488
https://abrahamshouse.net/
Island Volunteer Caregivers (206) 842-4441
www.ivcbainbridge.org
Kitsap County Volunteer Services
https://www.kitsapgov.com/BOC_p/Pages/ Volunteer-Current-Opps.aspx
Meals on Wheels Kitsap http://www.mealsonwheelskitsap.org/
Senior Companion Program (253) 272-8433/(800) 335-8433
http://www.lcsnw.org/tacoma/SeniorCompanion. html
RSVP, Retired & Senior Volunteer Program
https://lcsnw.org/program/retiredseniorvolunteerprogram-rsvp/
Senior Companion Program (253) 272-8433/(800) 335-8433
http://www.lcsnw.org/tacoma/SeniorCompanion. html
Volunteer Services Southwest https://ccsww.org/volunteer/
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