OutreachNC April 2020 by OutreachNC

COMPLIMENTARY

APRIL 2020 | VOL. 11, ISSUE 4

Telehealth: The Latest in Virtual Healthcare

The Railroad House: Sanfordâ&#x20AC;&#x2122;s Historic Legacy

Serving the Sandhills & Southern Piedmont

Turning Back the Clock: The Science of Skincare APRIL 2020

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| OUTREACHNC.COM

17 ANNUAL DEMENTIA & CAREGIVER SYMPOSIUM TH

TUESDAY, AUGUST 25, 2020 8:00 A.M. - 4:00 P.M. DENNIS A. WICKER CIVIC & CONFERENCE CENTER 1801 NASH STREET SANFORD, NORTH CAROLINA 27330 The symposium is for family and professional caregivers as well as community members wanting to learn more. Discover current trends in dementia care, practical self-care suggestions, and information about legal issues and technology to assist you in caregiving. Informational seminars, guest speakers, exhibitors, health screenings, door prizes and more!

REGISTRATION 8:00 A.M. | PROGRAM STARTS 9:00 A.M. LUNCH PROVIDED. Respite Care for Families Available & Arranged in Advance REGISTRATION REQUIRED: Please visit www.DementiaNC.org/Sanford2020 or contact Lisa Levine at: (919) 832-3732 or llevine@DementiaNC.org Family Caregivers, Clergy, Students, Volunteers & General Public: $10 Professionals: $40 | Continuing Education Contact Hrs. 4.5 For Questions or to schedule respite care, Please Contact: Holly Hight, Senior Center Caregiver Specialist, The Lee Co. Govt. Enrichment Center (919) 776-0501 ext. 2230 | hhight@leecountync.gov

HOSTED BY: 2

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Maintain Your Independence... Together, we can navigate your chronic care medical issues. Our Professional Aging Life Care™ Managers: • Make home visits to monitor results and coach clients on how to reach their goals • Manage medications for compliance • Provide support for doctor appointments • Provide information and referral services • Serve as a liaison for out-of-town family members • Provide support during a crisis

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features CONTENTS

New Release

w w w.mupress.org

Bells for Eli A Novel Susan Beckham Zurenda

866-895-1472

Susan Beckham Zurenda taught English for thirty-three years and now works as a book publicist for Magic Time Literary Publicity. A recipient of several regional awards for her fiction, including The South Carolina Fiction Project, The Porter Fleming Literary Competition, and The Southern Writers Symposium, she has also published numerous stories and nonfiction pieces in literary journals. Zurenda lives in Spartanburg, South Carolina. Learn more at www.susanzurenda.com.

NEW BOOK RELEASE: Bells for Eli

Also available in e-book format

TELEHEALTH: Help is just a click away!

TITlES OF INTEREST

“...one of the most exciting new voices in Southern fiction.” —Cassandra King Conroy, author of Tell Me a Story First cousins Ellison (Eli) Winfield and Adeline (Delia) Green are meant to grow up happily and innocently across the street from one another amid the supposed wholesome values of small-town Green Branch, South Carolina, in the 1960s and 70s. But Eli’s tragic accident changes the trajectory of their lives and of those connected to them. Shunned and even tortured by his peers for his disfigurement and frailty, Eli struggles for acceptance in childhood as Delia passionately devotes herself to defending him. Delia’s vivid and compassionate narrative voice presents Eli as a confident young man in adolescence—the visible damage to his body gone—but underneath hide indelible wounds harboring pain and insecurity, scars that rule his impulses. And while Eli cherishes Delia more than anyone and attempts to protect her from her own troubles, he cares not for protecting himself. It is Delia who has that responsibility, growing more challenging each year. Bells for Eli is a lyrical and tender exploration of the relationship between cousins drawn together through tragedy in a love forbidden by social constraints and a family whose secrets must stay hidden. Susan Beckham Zurenda masterfully transports readers into a small Southern town where quiet, ordinary life becomes extraordinary. In this compelling coming of age story, culture, family, friends, bullies, and lovers propel two young people to unite to guard each other in a world where love, hope, and connectedness ultimately triumph.

March 2020 | fiction 6 x 9 | 282 pp. | Hardback $25.00t | 978-0-88146-737-6 | H988 e-book $12.00 | 978-0-88146-750-5

38 Lightningstruck

Mother of rain

a novel Ashley Mace Havird

a novel Karen Spears Zacharias

Paperback | $16.00t | P540 978-0-88146-596-9 e-book | $12.00 978-0-88146-601-0

Paperback | $17.00t | P469 978-0-88146-448-1 e-book | $12.00 978-0-88146-450-4

A THRIVING MUSEUM: The Railroad House

44 You and i and Someone Else a novel Anna Schachner

Paperback | $18.00t | P541 978-0-88146-597-6 e-book | $12.00 978-0-88146-602-7

through the needle’s Eye a novel Linda Bledsoe

THE FIVE WISHES: Finding A Deeper Understanding

Paperback | $17.00t | P581 978-0-88146-702-4 e-book | $12.00 978-0-88146-703-1

50 cardinal hill

Save My Place

a novel Mary Anna Bryan

a novel Olivia deBelle Byrd

Paperback | $18.00t | P541 978-0-88146-573-0 e-book | $12.00 978-0-88146-581-5

TURNING BACK THE CLOCK: Advances in Anti-Aging Skincare

Paperback | $15.00t | P493 978-0-88146-501-3 e-book | $12.00 978-0-88146-503-7

ALZHEIMER’S AND DEMENTIA: What We Need to Remember

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At FirstHealth Moore Regional Hospital, itâ&#x20AC;&#x2122;s important that we take care of our patients and neighbors with dementia.

A Dementia-Friendly Hospital To learn more, visit

www.firsthealth.org/dementiafriendly APRIL 2020

OutreachNC.com 5 221-170-20

departments 10 12 14 16 18 20 22

24 26 28 30 62 64 66

BODY HEALTH: Pain Management and Opioids Lynn Fraser, MD

ASK THE EXPERT: Fall Detection Amy Natt, MS, CMC, CSA

PLANNING AHEAD: The Battle of the Sexes Nathan Cherry

GENERATIONS QUESTION: If you could invent something, what would it be?

FAITH AFTER 50: Faith: Timeless Connection The Rev. Colette Bachand

PHYSICAL THERAPY: Q&A Dr. Sara S. Morrison

HEALTH COACHING: Energy-Boosting Foods Callie Huneycutt, MS, RD, LDN CRAFTED: Cactus Creek Coffee and Chocolate Abegail Murphy BRAIN HEALTH: Diagnosing Dementia Dr. Maryanne Edmundson VETERANS CORNER: Leaving a Legacy Jim Pedersen

COOKING SIMPLE: Zucchini Bread Two fun ways to eat your veggies!! GREY MATTER PUZZLES Crossword, Word Search, Sudoku OVER MY SHOULDER: Lights in the Attic Ann Robson OUTREACHNCâ&#x20AC;&#x2122;S PHOTO OF THE MONTH An image to inspire us all.

RECIPES FEATURED THIS MONTH

Olive Oil Zucchini Bread Page 30

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Chocolate Zucchini Bread Page 31

Iced Coffee Tips Page 19

Pictured are attorneys Margaret (Mia) Lorenz and Michelle Stinnett of Lorenz & Creed Law Firm Michelle and Mia practice in the areas of Real Estate Closings, Estate Administration, drafting of Last Wills and Testaments, Revocable Living Trusts, Power of Attorneys, and Advanced Directives. Mia Lorenz also provides counsel on matters involving elder law, including information on the rules surrounding Adult Medicaid for long term nursing home care. Additionally, Mia Lorenz advises on guardianship and business law. Mia Lorenz is a graduate of Wake Forest School of Law and has practiced law since 1993. Michelle Stinnett is a graduate of Notre Dame School of Law has practiced law since 2013.

910-695-8688

www.LorenzCreedLaw.com 230 N. Bennett Street, Suite 2, Southern Pines, NC 28387 OutreachNC.com 7 APRIL 2020

from the editor This month, we’re celebrating and exploring science and technology. Readers, I won’t lie. I’m a feelings person. I celebrate words, novels, face-to-face conversations and the warmth of touch when the woman at Walmart puts her hand on my shoulder and tells me, “It’s okay, Baby Girl, we have more rotisserie chickens.” I have a love-hate relationship with science and technology because my brain just wants to live in a George Saunders short story (which ironically is often about science and technology) or in the kitchen baking zucchini bread (which I did this month to test a recipe) or flopped on the bed pondering the meaning of life (I fully appreciate an existential crisis). But I can’t ignore the beauty of science and technology either. I use Facetime to keep in touch with my siblings who live on the opposite coast. I still talk to my former students and friends from my glory days as a Peace Corps volunteer in China. I read books at stop lights on my iPhone and can listen to a book on an airplane instead of the man snoring beside me. I take medications that have been created because someone somewhere fell in love with science, and though I cannot read computer code, I kneel down in faint praise daily (figuratively) that someone else can and is willing to endure such boredom. This month, ONC looks at new developments in skincare and dermatology, a field rapidly expanding in technological advancement (p. 50), explores the latest science in the understanding of Alzheimer’s and dementia (p. 56) and to the wise words of scientific pioneers who blazed the trail for all the girls who have fallen in love with the field and study of science today (p. 35). We also head out to Lee County to explore a bit of technology from the past at The Railroad House in Sanford (p. 38). You can read all of this while you enjoy two kinds of zucchini bread in celebration of National Zucchini Day. I baked one myself and delivered it to thankful neighbors, so it’s locally verified and approved (p. 30). I like what Maria Montessori had to say about science, “We especially need imagination in science. It is not all mathematics, nor all logic, but it is somewhat beauty and poetry.” Likely, any scientist can attest to that.

Editor-in-Chief Amy Phariss | Editor@OutreachNC.com Creative Director & Designer Sarah McElroy | Coalfeather Art and Design Ad Designers Stephanie Budd, Cyndi Fifield, Sarah McElroy Proofreaders Abegail Murphy, Margaret Phariss, Kate Pomplun Photography Brady Beck, Mollie Tobias Contributors Brady Beck, Nathan Cherry, Maryanne Edmundson, FirstHealth of the Carolinas, Lynn Fraser, Callie Huneycutt, Sara Morrison, Abegail Murphy, Amy Natt, Crissy Neville, Jim Pedersen, Amy Phariss, Ann Robson, Jonathan Scott Publisher Amy Natt AmyN@AgingOutreachServices.com Advertising Sales Executive Kara Umphlett KaraU@OutreachNC.com Marketing & Public Relations Director Susan McKenzie SusanM@AgingOutreachServices.com Circulation 910-692-0683 | info@OutreachNC.com OutreachNC PO Box 2478 | 676 NW Broad Street Southern Pines, NC 28388 910-692-0683 Office | 910-695-0766 Fax info@OutreachNC.com

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The entire contents of OutreachNC are copyrighted by Aging Outreach Services. Reproduction or use without permission of editorial, photographic or graphic content in any manner is prohibited. OutreachNC is published monthly on the first of each month.

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TO the editor Amanda Bearse’s daily gratitude journal listing five things she is grateful for inspired me to do the same. So easy to focus on daily challenges. I want to get off that train and jump on the grateful train. I love the articles in the March issue. Bobbie, 72 After leaving the February issue of Outreach NC at my mother’s (while visiting her in NH) she proceeded to phone me three times in one day to discuss articles she enjoyed. I promptly ordered her a subscription. Thank you for the wonderful work! Laura S.

Don’t miss out on getting your monthly copy of

Thank you for your article health regarding vertigo and physical therapy. My mother suffers from vertigo, and I am going to be looking into help for her using physical therapy. I really appreciate having this information. Bob, 54 Dear Bob, Many readers called and emailed regarding Dr. Morrison’s article “Physical Therapy: Vertigo.” We failed to include the telephone number of her practice, Total Body Therapy & Wellness, which is located in Lillington. Let us remedy that now! To reach Dr. Morrison you may call 910-893-2850 and visit www.tbtwonline.com. Thanks for reaching out! Amy PHYSICAL THERAPY

Physical Therapy: Vertigo by Dr. Sara S. Morrison

Do you or a loved one have vertigo?

Do you want to feel better WITHOUT medicines or surgery? If you answered “YES” then keep reading!

Like I always say, when you’re dizzy and you don’t know which way the floor is… you’re sure to end up on it! Dizziness is a horrible condition. Many falls and injuries occur from dizziness or “vertigo.” So what can you do about it? Physical Therapy of course! (Really? PT for Vertigo?!) When I went to PT school, I remember being shocked that PTs could help treat dizziness. But it’s true and very effective. There are 4 main causes of vertigo:

1. The inner ear 2. Vestibular Occular Reflex (VOR) 3. Cardiac issues 4. Medication side effects

The inner ear provides important information on the position of our head and its movement in space. This is how you know you are “tilting” sideways. The inner ear can get overwhelmed, making you feel dizzy or nauseous. The inner ear is made up of 3 canals or tubes. These tubes have tiny microscopic crystals in them. When you turn your head to one side, the crystals on one side vibrate. This tells your body that your head is turning. These crystals help keep your head in the correct alignment and tell your body where you are.

If there are too many crystals in your ear, it can trick your brain into thinking that your head is moving when it’s not, hence the dizzy or spinning sensation. We call this Benign Paroxymal Positional Vertigo (BPPV). It usually occurs when you bend forward or look up. Why does this happen?

In short, we aren’t exactly sure, as there is a lot about the cause of BPPV we don’t yet know. Here are some fundamentals of BPPV: • • • •

It is common after an ear infection It can occur after you hit your head (i.e., a fall or car accident) You are more likely to get it as you get older You are more likely to get it if you’ve had it before

The good news is that we know how to treat it! Treatment is fast, easy, and cheap. Best yet, there are no medicines, shots, or surgery involved, and 97% of people are better after only 1-3 treatments! Are you unsure if you’ve had BPPV? BPPV can cause dizziness when a person: • • • • •

Looks up Gets out of bed Looks into a low shelf/cabinet Turns their head while driving, especially in reverse Lies flat

OutreachNC.com | FEBRUARY 2020

Thank you for bringing such an informative magazine to our community. The articles are relevant to the challenges we face as we grow older. We love the breadth of topics you cover and the way in which you present them. Keep up the great work! Bill & Lindsey, 60s

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advice

Our Aging Life Care ProfessionalsTM will answer any aging questions you may have. ASK THE EXPERT

Email us your questions! info@OutreachNC.com

Fall Detection by Amy Natt, MS, CMC, CSA

My mother is 76 years old, lives alone in her home and is still very independent. I have attempted to get her to wear an emergency alert pendant, in the event she has a fall and is not able to reach her phone to call for help. She is very resistant to the idea and has stated she will not wear it. I want to respect her decision but at the same time I worry about her. Do you have any ideas for an alternative?

Emergency alert pendants are indeed a great idea, especially when someone lives alone. Many offer GPS technology that allows them to be used from any location. This is key for someone who is still independent and on the go. Like many things, we often do not see the need for this type of safety net until a fall or other crisis occurs that prompts us to realize the value of receiving help with the push of a button.

I had a client report falling while at home. Her adult children had set up her Apple watch to notify them if a fall occurred. When she experienced a fall, it not only notified her children, but also her husband who was in another part of the house and emergency services were able to communicate with her through the watch to determine if she was conscious and if 911 needed to be called. It worked.

This is one area where technological advances are on your mother’s side. Many adults are finding exactly what they need through smart watches, smart phones and other fitness type wrist bands that can be worn all the time. They often serve multiple purposes and are fashionable or customizable. The key is making sure they offer fall detection capabilities.

Many companies are offering similar options. Apple is just one example; however, Fitbit, FitTech, Garman, Samsung, Phillips Lifeline, Lively by Greatcall and many more are offering fall detection technology. Some are synchronized with a smart phone and others are stand-alone devices. Do your homework and look at pictures of the wrist band available for each. Some are functional watches with lots of uses and others will have the appearance of an alert pendant. One thing to keep in mind is that the device will need to be charged and may require some degree of setup or input of information. Create a plan for daily charging. For example, a time she would be seated to eat a meal or watch TV and does not plan to be up and at risk of a fall. Some people charge them during sleeping hours, but if your mom is up and down to the bathroom, you would want her to be wearing it during that time. Together you and your mom can create a plan and choose the device that is the right fit for her.

A great place to start is by determining if your mom is already using some type of smart phone or watch that may have fall detection or emergency alert technology. There is a lot of information available online, if you do a quick search for “fall detection devices” or “fall detection wearables.” I will use myself as an example. I’m a runner and typically run alone. I am a single mom with children at home. Who would find me if I fell and couldn’t call for help? How long would it take? As a care manger my clients use this technology, but it recently occurred to me that I may need it myself. I already have an Apple phone and Apple watch. This made the process easy. I simply upgraded to a series 4 watch and enabled the fall detection option. Now if I am out running and experience a hard fall, my watch will automatically alert my emergency contact and call for medical assistance if needed. Just last month 10

OutreachNC.com | APRIL 2020

Readers may send questions to Amy Natt, an Aging Life Care ProfessionalTM, certified senior advisor and CEO of Aging Outreach Services. She can be reached at amyn@ agingoutreachservices.com .

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Generations

OutreachNC asked adults and children our April question. Share your answer on our Facebook page.

If you could invent something, what would it be? Calorie-free chocolate, obviously. – Amy, 44

A cure for cancer. – Sara, 54

A book that you read and you know everything they teach you in school so you can play the rest of the time. – Charlotte, 9

I’d go with the invention from the show The Jetson’s, the one where the mom presses a button and dinner is magically prepared. Yeah, that one. – Kara, 32

A vaccine for the Coronavirus. I’m just waiting for it to hit. – Judy, 62

A teacher who doesn’t give homework. – Simon, 9

A really cool, fast go-cart. – RJ, 6

Something to help people ambulate better. – Glenda, 60

A clone of myself. – Jennifer, 42

A cure for heart disease. – Chuck, 56

A breakfast my mom will let me eat that actually tastes good. – Jason, 6

Systems integration software. – Brett, 35

The perfect biscuit, which I wouldn’t have to invent but maybe reinvent from my Grandma Pearl. She died thirty years ago and took her biscuit recipe with her. – Lucy, 62 A translator machine so I can talk to my dog and he can talk to me. – Megan, 11

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A very small battery that can power a car, that powerful, but really small. You can’t imagine how useful that would be. – Mike, 50 Something so I don’t feel sick in the car. – Reagan, 12 A cure for cancer. – Randy, 69

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health

PHYSICAL THERAPY

by Dr. Sara S. Morrison, PT, DPT, CDT, FCE, CFT, Cert DN, Cert FMT I have noticed my posture has been worsening. I don’t stand up as straight as I used to. It makes me feel and look older than I am. How important is my posture to my health, and what can be done about it? Posture used to be thought of as cosmetic. Good posture makes you look better, more attractive, and even younger! But like many things, there is more to posture than meets the eye. Sure, posture does all these things. But did you know bad posture can make you ache? When you slump, many things happen. • Your head falls forward • Your neck muscles have to pull up on your head so your eyes can see what is in front of you • Your shoulders round forward • Your chest muscles tighten • Your upper back muscles over stretch and weaken • Your lower back rounds backwards When this happens, each of these areas becomes tight and weak. Pain can occur in any of these areas. This tightness does not allow your body to move the way it is supposed to. To help your posture and reduce pain and muscle weakness, try this: Slump forward: round those shoulders and stick out that head. Now lift your arm as high as you can. Keeping your arm at that spot, sit up straight. Now see if you can lift your arm any farther. You can, right? Probably a lot more! Your body is a machine. Like any machine, it works best if all the parts are in the right position. If you have poor posture, it is physically impossible to fully raise your arm. Imagine if you constantly slumped forward like that. Your shoulder and arm would have no choice but to tighten. That means your muscles would tighten and weaken and eventually stop working correctly. Then comes the popping, the cracking, the pain…the doctor. All because you didn’t listen when your mother told you to “stand up straight!” Let’s think about another example: 14

OutreachNC.com | APRIL 2020

You have back pain. You’ve been ignoring it. You are tough; it doesn’t bother you, and you can deal with the pain. But sometimes that pain gets bad…really bad. And it feels a little better, just gives you some relief, if you lean forward a bit. Sometimes you lean forward quite a bit. You even grab that grocery store shopping cart when you only need a few things, just so you can lean forward on the cart. But what about your balance? When you lean forward, your center of gravity is in front of your feet and not over your hips as it should be. If you lose your balance – slip on a wet floor, trip over something, misstep on the grass – you need to react fast to catch it. And if your center of gravity is not where it should be, it is much harder to do this. Your hips and legs physically cannot move as fast or as far in this posture. Poor posture greatly increases the chance of you falling, all because you didn’t address that initial pain. But there is help! Simple stretches and exercises can get your posture back to normal in no time. Even better – it is covered by your health insurance! Anything that restricts your movement, limits your strength, or causes you pain is covered by your health insurance. This includes your posture. An evaluation with your physical therapist will best assess which treatment is best for you and your posture. No doctor referral is required! Are you ready to take back control of your life and your balance? Give physical therapy a try.

Dr. Sara S. Morrison PT, DPT, CDT, FCE, CFT, Cert DN, Cert FMT Owner of Total Body Therapy & Wellness in Lillington Tel. (910) 893-2850

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health

H E A LT H C O A C H I N G

Energy-Boosting Foods: The low-tech way to feel your best by Callie Huneycutt, MS, RD, LDN

Ever feel like you hit a slump everyday around 3pm? Maybe you start dozing off while watching TV or suddenly have a wave of fatigue while out running errands. You may notice you have a hard time maintaining motivation to get to the evening exercise class. What are we missing in all of these situations? Energy. Energy is defined as, “the strength and vitality required for sustained physical or mental activity.” Why is sufficient energy so difficult for many of us to acquire or maintain? Often we develop an energy deficit due to a variety of reasons: hectic schedules, inadequate sleep, stress, poor eating habits, chronic health conditions, or even medications. Energy is actually closely related to our metabolism. Our metabolism is the rate at which our body processes nutrients (aka food!) for energy. The energy created is what allows our body to function properly and sustain life. The definition of a calorie is energy. Our bodies require food for energy the same way our cars require gas for fuel. If we are not providing our bodies with the right type of fuel, and enough of it, how can we expect to feel our best? While sometimes a decrease in energy may be the result of medical conditions beyond our control, many aspects of our lifestyle can also contribute. Adequate Calories = Adequate Energy Sometimes we just don’t eat enough, at least not enough for our bodies to effectively do the things we need them to do. For various reasons, like busy schedules or even trying to lose weight, we may be more inclined to skip meals or go long periods of time without eating. When we don’t provide

OutreachNC.com | APRIL 2020

ourselves with adequate calories, our body has to compensate for the lack of energy. Think of this like your cell phone going on “low power mode” in order to conserve energy if your battery is low. For this same reason, it is a good idea to avoid overly restrictive diets. One of the hallmark symptoms of low calorie or low carbohydrate diets is noticeable fatigue. You can often see an increase in your energy level by just making sure to eat something every 3-4 hours. On the other hand, overeating can also cause you to feel sluggish. Think of how you may feel after Thanksgiving dinner or a big meal. Your body has to use energy in order to break down food and absorb nutrients. When we eat too much at one time, it causes our body to overwork and use too much energy, which in turn can lead to feeling lethargic. Overeating can also affect sleeping patterns, and good quality sleep is essential for maintaining energy throughout the day. Balance matters Making sure your meals and snacks are balanced amongst macronutrients (carbohydrates, protein, and fat) can help create sustained energy. Our body metabolizes, or breaks down, each of these nutrients differently. Carbohydrates are a good source of quick energy; however, they are digested rapidly, and we often feel an energy “crash” shortly after eating them. On the other hand, protein and fat take longer to break down. When we eat carbohydrates together with protein and fat, we usually stay more satisfied and have longer lasting energy. Here are some easy snack options that provide good sources of protein, fiber, or healthy fats:

• Apple and peanut butter • Handful of nuts with fruit • Greek yogurt topped with fruit • Carrots or celery with hummus • Whole grain crackers with low-fat cheese or peanut butter • Whole grain toast with avocado • Cottage cheese with fruit Choose high-quality “fuel” Adequate micronutrients (vitamins and minerals) are equally as important. Our bodies run more efficiently when we eat nutrient-dense foods. With a diet consisting of a variety of fruits, vegetables, whole grains, lean proteins, and healthy oils, we are providing our body with “high-quality” fuel. For energy, we need good stores of iron, B vitamins, magnesium, vitamin D, and omega-3 fatty acids. These antioxidant-rich foods can even help with mental clarity and focus. Eating foods that are poor sources of micronutrients, like those made with refined carbohydrates (sweets, breads and pastries made with white flour, salty snacks, and fast food), lack the essential nutrients our bodies need and don’t set our metabolism up for success. Make sensible beverage choices It can be tempting to reach for another cup of coffee or a soda in order to get a quick burst of energy. Unfortunately, that is often all it is: a quick, temporary jolt of energy that may bring you crashing down an hour later. Similarly, be mindful of alcoholic beverages. Alcohol is a depressant which can affect one’s energy level even many hours after consuming it. It can interfere with good, quality sleep leaving you feeling groggy the next day. In addition, be sure to drink adequate water. Water is actually one of seven major classes of essential nutrients, meaning we have to supply ourselves with adequate amounts through food and drink for our body to function properly. A good goal to start with is getting at least 64 ounces of water daily.

Celebrate Life

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Get moving In addition to having a healthy, balanced diet, one great way to increase your energy level is to increase physical activity. Getting consistent physical activity helps support a healthy metabolism. It is recommended that all adults get at least 150 minutes per week of moderate physical activity. This could include a brisk walk, strength training, dancing, water aerobics, or participating in a sport. If physical activity is not typically a regular part of your routine, try breaking up your day with short, 10-minute bursts of activity and increase as you are able.

Callie Huneycutt, MS, RD, LDN is a Health Coach and Registered Dietitian at Pinehurst Medical Clinic in Pinehurst and Sanford. She can be reached at 910-2353347 or chuneycutt@pinehurstmedical.com.

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life

CRAFTED

Cactus Creek Gourmet Coffee Roasters & My Sweet Handcrafted Chocolates by Abegail Murphy

With all of this talk about new-fangled technology, it’s nice to remember that some of the best treats are the most traditional, the simplest in form and the ones we’ve loved the longest. When we pair them together, the possibilities are endless, which is what local coffee roaster Cactus Creek does in providing locally-roasted and brewed coffee with handmade chocolates from My Sweet Handcrafted Chocolates. ONC’s Abegail Murphy explores both the strong and the sweet sides of one of life’s best combinations. Cactus Creek Gourmet Coffee Roasters was established in July of 2004 by a group of retired Special Forces Army veterans with a taste for good coffee and good company. One of these founders, Mike Birky, can still be found at the brick-and-mortar location in Aberdeen, where he works day in and day out with his crew to ensure top-quality care for every client who walks through the door. Today, Cactus Creek offers over fiftyfive different flavors of coffee, twentyfive varieties, and an extensive selection of unique house and proprietary blends. Though there are definitely some seasonal favorites—namely “Pumpkin Spice” in the fall and “White Chocolate Raspberry Truffle” in the winter—these seasonal treats are available year round, which is something that cannot be found at most (if any!) other coffee retailers. If you find yourself longing for Pumpkin Spice in April or a Candy Cane blend in July, Cactus Creek has your craving covered. Never heard of Cactus Creek Coffee before? If you’ve made a stop at a local coffee shop, there’s a good chance you’ve already had it! Cactus Creek supplies coffee to around eighty percent of local coffee shops in the Sandhills region thanks to their exotic blends, selection of organic products, and loyalty to both their customers and the community. “Our customers know us,” said owner and founding member Mike Birky. “We make sure we can provide to our clients. We want the community to flourish and grow. We’re there every step of the way.” 18

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Swing by Cactus Creek Coffee and pick up a custom blend, gift card, or customizable gift basket for your most beloved coffee fanatic. Gift baskets can be customized to include coffee products, home products, and melt-in-your-mouth chocolate products from My Sweet Handcrafted Chocolates. Carole Soxman, owner and sole chocolatier of My Sweet Handcrafted Chocolates, took her first chocolatiering class four decades ago. Her passion for the craft was immediate. Over the years, Carole has refined her hobby into an expertise, motivating her to open a prosperous business right here in the Sandhills. Now, My Sweet Handcrafted Chocolates provides clients with a one-of-a-kind assortment of delectable treats year round. Combining unique flavors, creative shapes and custom packaging adds up to the recipe for the perfect candy company. Custom orders and special requests are no challenge for this chocolatier. Carole uses an extensive selection of toppings and fillings — nuts, nut butters, dried fruits, fruit purees, caramel, toffee and coffee…you name it, she has it — for any customized order that comes her way. Though Carole creates bonbons, barks, Sweetie Pies, and bars of all flavors, the fan favorite has remained her homemade Espresso Bark for quite some time. Fans of her coffee flavored delicacies can even find her candy supplied in Cactus Creek Coffee gift baskets, created in a custom made Cactus Creek logo mold. In addition to Cactus Creek, My Sweet Handcrafted Chocolates is sold in more than a dozen retail locations throughout the state, with a full list available on the official website, making it easy to pick up or order a box or bag of some of the finest gourmet chocolate North Carolina has to offer. To find out more about Cactus Creek Coffee, visit their website at cactuscreekcoffee.com or find them on social media. For more information on My Sweet Handcrafted Chocolates, log on to Carole’s website at chocolatesbymysweet.com or find My Sweet Handcrafted Chocolates on Facebook.

Iced Coffee With summer right around the corner, we are considering our cool beverage options. Besides wine spritzers, mint juleps and good old fashioned water from the garden hose, we’re beginning to hanker for iced coffee. Here are three ways to brew the beverage that gets us up and keeps us going...all morning, day and year long. Classic Cold Brew Combine coarsely ground coffee beans and water (in a French press, for example), wait and then strain. We used to call this “Cowboy Coffee” during my Peace Corps days, when we used tea strainers and tin mugs. No matter what you call it, pour that elixir over ice and pair it with chocolate. Japanese Iced Coffee Method Popular across the web, Japanese iced coffee is a method of brewing coffee with less water (particularly with the pour-over method) to brew a stronger, heartier coffee. The idea is that, when the hot coffee hits the ice, the coffee with be perfectly diluted and not overly-diluted. We know. Brilliant. Vietnamese Iced Coffee Even for those of us who don’t add sugar to our coffee, we somehow have a soft spot in our hearts for Vietnamese Iced Coffee. It’s simple and easily made at home; although we love it with Thai and Vietnamese food on a hot day, the perfect juxtaposition to the spices of a Panang Curry or Ca Ri Ga. For the recipe, simply pour sweetened condensed milk into a glass, add coffee and stir. Then, add your ice, mix it together and enjoy.

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health

B R A I N H E A LT H

Diagnosing Dementia: Brain Scans & Neuropsychological Testing by Dr. Maryanne Edmundson

Sometimes clients ask me, “Why can’t I just get a brain scan to see whether I have dementia?” The answer is that neuroimaging techniques, such as CT scans or MRIs, can be helpful but may not show all the information necessary to determine the presence or absence of dementia. For the greatest certainty, a person concerned about dementia should obtain a neuropsychological evaluation. What is Neuroimaging? Neuroimaging is essentially taking a specialized picture of the brain or spinal cord. It shows structure, so it is useful to determine if there are visible changes to the brain, like the development of a tumor or a stroke, that can affect brain functioning. Such scans are especially helpful when a person has a sudden change in functioning (such as difficulty speaking or walking) to evaluate whether quick treatment is needed (such as whether a person should be given medications like TPA to reduce the effects of a stroke). Neuroimaging may also be used to rule out structural brain changes if a person is unable to give meaningful responses to Q&A type testing. However, when it comes to some dementia conditions, such as Alzheimer’s disease, neuroimaging may only show structural changes once the condition is sufficiently advanced to cause visible atrophy in certain brain areas, like the inner temporal lobes. Some studies suggest that MRIs are more likely to show false negatives (i.e., to say a person does not have the disease when they actually do) early in the disease progression (Richard et al., 2013). What Information Does Neuroimaging Not Provide? 20

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To determine whether a person has dementia, you need to know how they are functioning day to day. Most widely available neuroimaging techniques (CT and MRI) do not show how well the brain is working – they will not tell you if the brain tissue you see on the scan that looks healthy is actually doing what it is supposed to do. Although some brain scans can evaluate narrow functional processes (e.g., EEG shows electrical activity on the brain’s surface, FDG-PET shows how the brain is using glucose) and may relate to daily abilities, they do not necessarily tell specifically how this translates into daily functional performance. Even if there is visible atrophy or functional imaging findings to suggest a particular brain area is not functioning correctly, such scans may not always help your doctor distinguish whether you may have one of several similar conditions. For example, people with Parkinson’s disease may have similar functional testing of dopamine use (a chemical used for brain cell communication) and atrophy patterns to some people with dementia with Lewy bodies and more evaluation is required to determine which they have. What Is a Neuropsychological Evaluation? The gold standard to determine whether someone has dementia is a neuropsychological evaluation. This is a comprehensive assessment of a person’s specific symptoms, functional abilities, and medical and emotional history gathered through interview, paired with active testing of how a person’s brain is functioning through paper and pencil tasks. Here, a clinician can see that a person is having memory difficulties (e.g., by having them attempt

to learn and remember new information) and can put that into the context of their life, including determining whether there has been a change from a person’s previous functioning (even if it is not yet frankly impaired), whether reversible causes of cognitive changes are present (such as medication effects or depression, which cannot be determined by imaging alone), what brain areas are struggling (because certain cognitive tests utilize different brain areas), whether there is a pattern of functional difficulty that fits one dementia vs. another, and what resources or other evaluations may be helpful. Because so much information about the whole person is gathered, a neuropsychologist is able to tailor treatment recommendations to each individual person. If you have questions about getting a neurocognitive evaluation, consult with your primary medical provider for referral to a local neuropsychologist. Dr. Maryanne Edmundson is a clinical neuropsychologist at Pinehurst Neuropsychology Brain & Memory Clinic. She can be reached at 910-420-8041 or through the website at www. pinehurstneuropsychology.com.

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advice

VETERANS CORNER

Leaving A Legacy by Jim Pedersen

Every day veterans of all ages share their stories with me. They recount harrowing tales of battles, captivity and injury and heroic stories of courage, perseverance and ingenuity. But they also share heartwarming accounts of service camaraderie, lifelong friendship and humor found in the most unlikely places and events. In addition to giving the details of their service, they share deeply personal and moving stories of how their military service shaped and changed their lives – for both good and bad. They often tell me they want to record their experiences for future generations, so they will remember the past and allow it to guide their future. The Library of Congress is offering veterans a way to do just that through the Veterans History Project. Coordinated by the American Folklife Center in Washington, DC, the project aims to collect and preserve personal accounts of American war veterans so that others can hear these firsthand accounts and through them, better understand the realities of war. Veterans History Project’s curators are collecting information about U.S. Veterans beginning with World War I. They are seeking information about people who were part of combat operations and American interventions as well as those who served during the Cold War.

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Veterans are encouraged to share personal narratives, written memoirs, correspondence such as letters, postcards, diaries, and visual materials including photos, drawings and scrapbooks. Family members of deceased veterans are also encouraged to participate by sharing memories of their loved one, retelling the stories they told, and providing memorabilia and other military-related materials that belonged to their veteran. These narratives and accompanying memorabilia will be preserved at the American Folklife Center but the information is also available for viewing online at Veterans History Project website, www. loc.gov/vets/. The website features many moving video interviews with veterans of all ages. Congress created the Veterans History Project in 2000, but there has been a renewed effort to encourage veterans to share their stories. Locally, U.S. Congressman Richard Hudson’s staff is inviting local veterans and their families to schedule an interview through their office so that they can share and preserve their military story. The Congressman said he became interested in the project because he believes every veteran deserves to have their story and experience told. “That’s why I have partnered with the Library of Congress through the Veterans History Project to highlight veterans in

our own community. This project will make sure veterans from our region will have their stories preserved in the Library of Congress so that current and future generations can learn from their experiences and respect their service to our nation,” Hudson said. I spoke with Bekah Bibb, Constituent Services Liaison for Congressman Hudson, who is conducting veteran interviews on the second Tuesday of each month. The location alternates between Fayetteville and Pinehurst, depending on the location of interested veterans. During the course of the conversation, veterans are encouraged to share stories of their childhood and their family, recount what led them to military service, talk about what happened during their service, and finally, share how they fared after their discharge. They may bring photos, medals, letters or any other memorabilia that is important to them. They can also bring photos of other soldiers with whom they maintained lifelong friendships after their service ended. The interviews range in length from at least 30 minutes to 45 minutes or more. Because these interviews delve deeply into each veteran’s experience, appointments are necessary. To schedule an interview, call Bekah at 910-9972070 on Monday, Wednesday or Friday, and at 910-246-5374 on Tuesdays or Thursdays. “We have so many veterans here who have retired, especially in Moore County and Fayetteville,” Bekah stated. “So many of them don’t believe that their story is worth sharing. For our future generations, it is something that needs to be preserved. There are going to be kids, a generation from now, that can look up what their great-great-grandfather did in WWII,” she noted. Like Bekah, I, too, have had many veterans downplay their service and their stories. However, all veterans have a story to share and it is important to preserve these stories for future generations. I encourage Moore County Veterans to submit their life stories to the non-partisan, non-political Veterans History Project so that others can know of their service, their sacrifice and their support of our nation. The Moore County Veterans Office assists Moore County veterans with submitting disability and other VA claims and provides referrals to community resources. Appointments are needed and may be made by calling the office at 910-947-3257. Office hours are 8 a.m. to 5 p.m. Monday through Friday.

VSO Jim Pedersen, right, is the director of the Moore County Veterans Service Office. Experienced nationallycertified VSOs Kelly Greene, and Robert “Bob” Hall, a Vietnam-era veteran who retired from the Army after 30 years of service, assist Moore County veterans with their disability claims.

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APRIL 2020

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health

B O D Y H E A LT H

Pain Management: Understanding Opioid Medication for Acute and Chronic Pain

by Lynn Fraser, MD months). In fact, current CDC guidelines include opioid Last year, OutreachNC Magazine published a four-part medications as a “non-preferred,” meaning not first line, series exploring the opioid crisis from many different therapy for chronic pain. It is important to note that this perspectives including how it affects communities, families does not include cancer treatment, palliative, and end-ofand individuals. We reached out to Pinehurst Surgical’s Dr. Lynn Fraser, who specializes in pain management, to better life care, in which cases opioid medications are in fact used, generally in a more liberal manner. understand opioid use for pain management including myths about opioid use, alternatives for pain management ONC: How can a patient begin a conversation with his/her and transitioning from opioid-based pain management to healthcare provider about opioid use? Is this a conversaother methods. tion to have before opioid use begins or only if a ‘problem’ We are grateful for Dr. Fraser’s insight into this important issue.

ONC: How does regular opioid use for pain turn into addiction? Is there a tipping point, so to speak (a time frame or dosage) that is a marker for people to indicate addiction may be on the horizon? LF: There is no specific time frame or dosage that is indicative of addiction. However, concerning behaviors include taking the medication more frequently than is prescribed or at a higher dosage than is prescribed and/or experiencing cravings for the medication. Physicians use a risk assessment tool to indicate the likelihood of opioid abuse. A combination of the following indicates a patient that might be at higher risk: family or personal history of alcohol or drug abuse, age less than 45, history of preadolescent sexual abuse, and psychiatric diseases, including depression. ONC: What is the biggest misconception about opioid use in the aging population? LF: The biggest misconception in the aging population is the fear of addiction. While this is certainly a concern, studies have shown that older age is associated with a much lower risk of opioid abuse, estimated to be as little as 3% of patients over age 65 that are prescribed opioid medications for non-cancer pain. ONC: What is the biggest myth about opioid use for pain management? LF: The biggest myth is that opioids are that the mainstay treatment for chronic pain (defined as pain lasting >3 24

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emerges? If a patient is referred, for example, to pain management, does the patient need to discuss opioid use with his surgeon, family care doctor or the pain management doctor? LF: Patients can ask their healthcare provider if opioid medications are appropriate to incorporate as part of their treatment plan. If they are already taking opioid medications and would like to make a change, patients can ask if they are candidates for alternative therapies to use in conjunction with or instead of their current medications. It is important to incorporate all healthcare providers providing care for patients in the decision-making process as far as opioid medications. ONC: Can you provide examples of alternatives to opioids for long-term pain management? LF: The mainstays of pain management include medications, physical therapy, and/or interventional management. There are many medication alternatives to opioids; for example, neuropathics (medications that work at the level of the nerve), non-steroidal anti-inflammatories, muscle relaxants, and anti-depressant medications are used alone or in combination to manage pain long-term. Physical therapy is another option that can help patients, especially if the exercises are continued at home. Interventional management, injecting steroid into the area of inflammation under x-ray guidance, can be incredibly efficacious in relieving pain as well, which is the focus of my practice. ONC: What are the biggest impediments for people seeking alternative therapies? Is insurance an issue? Is lack of information an issue? Do doctors themselves lack knowledge

of these alternatives, thereby limiting the discussion with patients? Are patients reluctant to try alternative therapies for fear of being in pain or lacking results? LF: We have excellent results in insurance coverage for the above outlined therapies. However, insurance typically does not cover therapy such as massage, acupuncture, and investigational medications like ketamine infusions and CBD oil. Most physicians are well-versed in alternative therapies, especially in recent years with stricter guidelines surfacing about the prescribing of opioid medications. In fact, it is commonplace for surgeons to implement alternative therapies as part of their operative protocol. Patients can in fact be hesitant to try alternatives for fear that these treatments will not relieve their pain. Neuropathic agents are not medications that you take and feel a reduction in pain some minutes later, as with opioid medications. They impart their effect at the nerve terminal slowly, over time; many patients do not realize how much these medications are actually helping them until they discontinue them. ONC: What role do family members and loved ones play in helping someone transition from opioid-based pain management to alternative therapies? LF: The best way a family member can support their loved one is to maintain an optimistic attitude and to provide encouragement. It is important to keep in mind that there is usually not a “magic bullet” that will help 100% of the pain. Often, long-term pain management looks closer to a piecemeal approach. For example, a medication may help 20%, an additional medication may provide another 30% of relief, physical activity may provide a 20% reduction in pain, and social support can often provide the last bit of improvement. The impact of strong social support in a patient’s prognosis is often underestimated and has been shown to be instrumental in recovery and healing. ONC: How do opioids impact older adults differently than younger adults? Do we metabolize medication differently? Do our bodies respond differently?

There are certainly considerations in opioid metabolism as part of the normal aging process. Alterations in the GI tract, decreased blood flow to the liver and kidneys, and reduced muscle mass can all result in opioid medications being more potent and having a longer duration of action than predicted. Other considerations include polypharmacy and medical comorbidities, meaning an older patient is more likely to be on several medications and to have other medical diagnoses, all of which must be taken into account when prescribing medications. ONC: Are clinical trials available for alternative therapies in pain management? Is this something people in chronic pain might consider? LF: This is certainly a consideration, as treatment for pain is highly investigational in nature and constantly evolving. Clinicaltrials.gov is a website with the most up-to-date information about trials that are now enrolling. ONC: What are the biggest side effects of opioid use that might be reduced by using alternative therapies for pain management? LF: The most commonly reported side effect from opioid medications is constipation, which can be severe and unresponsive to standard laxative medications. This side effect typically resolves after the medication is discontinued. Depressed mood is another common side effect seen with opioid medications, especially with long-term use. Perhaps the most feared side effect from opioids is respiratory depression, which is not a concern with alternative therapies. Lynn Fraser, MD specializes in pain management at Pinehurst Surgical in Pinehurst, NC. She can be reached at 910-295-6831 or through her website at www. lynnfrasermd.com.

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advice

PLANNING AHEAD

Battle of the Sexes: 3 Areas Men and Women Differ Financially by Nathan Cherry

Of all the certainties that exist in creation, perhaps none is more certain than this: men and women are different. Opinions, experiences, and research all conclude that men and women are indeed different. From our biological differences, to the way we view our world, there can be no doubt that the sexes approach things from varied angles. But if men are from Mars and women are from Venus, it should come as no surprise that the relationship men and women have with money and finances is often very different as well. Add personality types, biases, the example of our parents, and suddenly the differences in perspective grows dramatically. BIOLOGY & NATURE The research concluding men and women come at money from different perspectives is growing. Some studies suggest the difference is due to the fact that men tend to be hunters and women are often gatherers. These hardwired traits for men of competitively seeking more and making sure they have enough is just as inherent as the desire of women to hoard and find comfort in what they have. One researcher describes these differences by saying that men “go out and buy a shirt, wear it until it dies, then go out and kill another shirt. Women, in contrast, gather. They shop for this for next Christmas for their niece and for that for their son-in-law.”

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The nature of men will often lead them to see the world as hierarchical and competitive. As with any good competition, there are winners and losers, which means men may focus on competition while women may view the world as more of a co-op with opportunities to share and work together. While women may view the world as more of a co-op with an opportunity to work together and share. Women tend to share their talents, skills, resources, and even power with one another in order to contribute positively to the co-op (i.e. society). In dealing with money, these differences often present themselves in a man buying a new car without first consulting his wife. She will wonder why he didn’t include her in the decision when he viewed the task as a competition to get a good deal and provide for his family. Conversely, men will seek to combine family finances in order to consolidate perceived power and make management easier. This can often make a woman uncomfortable, believing her husband will seek to control her and refuse to share the management of finances with her. CONFIDENCE One of the most researched topics concerning the sexes and money is that of confidence. Research suggests men often feel far more comfortable in their decisions around money than women. One study concluded: “58% of men feel more confidence toward their money and finances,

compared to 44% of women. Females also feel more anxiety toward finances (33%) than men (18%). This may account for why 28% of the male respondents reported to always negotiating their salary, compared to only 19% of women respondents.” Many women grew up watching their fathers manage the family finances, pay the bills, make large purchases, sign financial documents, and serve as the primary bread winner in their homes. Couple this vivid picture with a lack of practical financial training in school and it’s easy to understand how men could be viewed as more competent and skilled with money. A Forbes article on this topic said such a conclusion is “unfounded,” and stated that “women’s ability to make good decisions based on both fact and intuition is actually quite good.” PRIORITIES AND CONCERNS These differences also account for the variations in financial priorities of men and women. Whereas men are often more interested in investing and entrepreneurship, women lean towards the themes of savings and frugality. Knowing this, it’s no surprise that men tend to spend their excess cash on technology and electronics, while women prefer travel. The hunter in men will drive them to “live for today” because “you can’t take it with you when you die.” But the gatherer in women will seek stability and security through reducing debt, living frugally, saving, and learning more about modern financial trends such as F.I.R.E.

to become more skilled each day, and to pass on valuable lessons to the next generation, is a critical need. Exercise: How can men and women move towards the middle and find common ground in the way they view money and the resources they have been entrusted with? Try this simple exercise. First: Each week, do something that doesn’t come naturally; if you’re a spender, save a little. If you’re a hoarder, be generous to someone else. This will move you and your partner closer to the middle and help you step out of your comfort zone. Second: Every time you do something that doesn’t come naturally, write down how it makes you feel, or discuss it with your partner. Third: Treat yourself for trying something new and making some progress. Nathan Cherry is a financial adviser and planner with Hicks & Associates in Southern Pines, specializing in comprehensive financial planning and asset management, as well as offering a range of other services. He can be reached at 910-692-5917.

Aside from different priorities, even the financial concerns of men and women differ. Men don’t often voice financial concerns, but when they do, they revolve around providing for their family (a house, food, clothing, etc.). This is often considered a short-term (but necessary) goal. Women, however, living longer on average than men, look down the road into the future and focus their concerns on having enough money to provide basic needs and healthcare costs for many years. Again, the hunter and gatherer motifs are in view even as the bills are being paid. Many things about men and women are clear as mud. What is crystal clear is that biology and nature, combined with upbringing and education, contribute to many of the differences between men and women concerning money. However, it must be noted that these are not insurmountable obstacles. We often overcome our own nature and our childhood to achieve great accomplishments. That we can do the same concerning our abilities with money is certainly true. That we should strive to overcome our weaknesses in the area of finances,

305 Page Road | Pinehurst, NC 910.295.1010 | frontoffice@wellenerdental.com APRIL 2020

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life

FA I T H A F T E R 5 0

Faith: Timeless Connection by The Rev. Colette Bachand

In light of this month’s theme of “science and technology” at Outreach NC, I began wondering whether Jesus would have used text messages and whether Buddha would have had a Facebook page?

utterly connected to. When we are in the “thin place,” we are transformed and strengthened. “Thin places” are moments we cannot deny we are connected to something bigger then ourselves.

Would Mohammed have tweeted? Would Moses have used Instagram?

Some people say we find these “thin places” on mountaintops, in grand cathedrals or beautiful vistas that take our breath away. But I would suggest we don’t need to climb Mt. Kilimanjaro or travel to temples of India to feel them; we have the same opportunity in the mundane, the ordinary and the everyday.

My conclusion is that they probably would have, a realization that makes me consider how much I resist technology even if it means I can send and receive messages any time, anywhere, with people I love. There’s something inside of me that wonders if carrier pigeons must have been a great way to exchange messages back in the day. You could write a letter, send the little bird off and then sit and wait, read a book, cuddle up by the fire, and even have time to start an herb garden before your message came back. Now it seems we can’t get through a meal, a movie, or a visit without something beeping to tell us we have a message. Whether by carrier pigeon or email, the truth is, feeling connected is healthy for our spirits, and feeling a connection with God can mean a great deal as we age. In the second half of life, we are less constrained by schedules and commitments leaving us more time, if we choose, to try spiritual practices like meditation, journaling, Bible studies and drumming circles. Because we aren’t in such a hurry, we find our connection with God deepened when we are standing in front of a sunset and decide we must paint it, even though we’ve never held a paintbrush before. With a quieter lifestyle and the need to take breaks and rest, we experience the God who connects with us as a “still small voice.” Life has also taught us we can feel connected to God in places and ways we might not have noticed in our youth. Eyes and hearts graced by time and years give us the capacity to feel connections with the Divine in the gaze of a grandchild, the drive to the doctor’s with a spouse, and dinner with people who were strangers just months ago, but now, since moving to a new place, they are our closest pilgrims on the journey. Our lives have already had the experience of being in what Celtic spirituality calls “thin places,” moments and places where it seems the space between heaven and earth have met and we experience God in a way we can’t explain but feel 28

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I once saw a bumper sticker that said, “Prayer: the original wireless connection.” I like that thought because prayer is an emptying of the soul that makes room for God to do God’s work and connects us in a holding of trust and hope. I like that thought because it reminds me I have everything I need to feel connected to God - I don’t need a perfect prayer book, or perfect candle to light, or perfect place to sit to pray. God is already there; the connection is already made. So how are you staying connected to God? The alternative to not being connected to God (the Divine, Creator, Higher Power) is loneliness, and quite frankly, loneliness is one of the leading causes of physical and mental decline for anyone, but especially for older adults. As the earth reaches out to connect with us this season, opening itself with colors and new life, I pray you find connections with our Creator who loves and longs to walk with you. Whether by prayer, emails, text messages or even carrier pigeon, stay connected to that which nourishes you. Look for the “thin places” where God waits. And if you do get a text message from Jesus, will you let me know? I’d like to have coffee with you.

Rev. Colette is an Episcopal priest who has the honor of serving as Chaplain at Penick Village in Southern Pines and has worked in geriatric care for 15 years. cwood@penickvillage1964.org

Music

can name the unnameable and communicate the unknowable. - LEONARD BERNSTEIN

It has always been universally understood that listening to favorites is enjoyable and can lift oneâ&#x20AC;&#x2122;s mood. However, during the past few years weâ&#x20AC;&#x2122;ve come to better understand that therapeutic value music can have on those with dementia. For qualified individuals, AOS & Friends Care offers a program which provides a music player loaded with personalized songs.

lp?

To learn more about the Personal Music Player and other AOS & Friends Care programs/services:

o W E Do T

910.585.6757 info@aosfcare.org www.aosfcare.org APRIL 2020 OutreachNC.com www.facebook.com/AOSFriendsCare

life

l i O e v i l O i n i h Zucc Bread

COOKING SIMPLE

April 23 is National Zucchini Bread Day. Here are two versions sure to please whomever stops by for a cup of tea or pops in to get out of the rain. Olive Oil Zucchini Bread – adapted from Melissa Clark’s recipe published in The New York Times

We made this on a snow day, when the Sandhills were all but shut down, and we had a hankering for something bright and cozy. This bread was perfect. The citrus was a welcome surprise, and the bread was tender, moist and best served warm with Irish butter slathered across each slice. We think this would make excellent muffins, which we plan to try next time, cutting the baking time to 35 minutes. Let us know which way you try it and if you love the lemon zest as much we do! Ingredients • • • • • • • • • • • • •

1 ½ cups grated zucchini (approximately one zucchini) 2/3 cups light brown sugar 1/3 cup olive oil 1 individual carton vanilla Greek yogurt (at least 2% but whole milk is better) 2 large eggs ½ tsp. vanilla extract 1 ½ cups all-purpose flour ½ tsp. salt ½ tsp. baking soda ½ tsp. baking powder 1 ½ tsp. cinnamon ¼ tsp. nutmeg Zest of one lemon

Directions 1. Preheat oven to 350 degrees F. Brush an 8-inch loaf pan with butter (or cooking spray). 2. In a large bowl (we used a KitchenAid), combine wet ingredients including zucchini, brown sugar, olive oil, yogurt, eggs and vanilla extract. 3. In a separate bowl, whisk together flour, salt, baking soda, baking powder, spices and lemon zest.

4. Fold the dry ingredients into the wet, careful not to overmix.

5. Pour the batter into the prepared loaf pan and bake for 40 – 55 minutes, rotating the pan at the halfway mark. Bread will be done when a toothpick inserted into the center comes out clean. 30

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6. Cool in the pan for 10 minutes. Run a knife around the edge of pan and remove the bread from the pan allowing it to cool completely before slicing.

e t a l o c Cho i n i h c c Zu ad Bre Chocolate Zucchini Bread

Directions:

We believe, ardently, that chocolate makes everything better, even zucchini. This bread proves this theory to be true.

1. Preheat the oven to 350 degrees F and place the rack in the middle of the oven. Grease a 9x5-inch loaf pan with butter or baking spray.

Makes one loaf but is easily doubled. Ingredients • • • • • • • • • • •

2 cups freshly grated zucchini 1 ¼ cups all purpose flour ¼ cup unsweetened cocoa (not Dutch processed) 1 tsp. baking soda ¼ tsp. salt ½ tsp. cinnamon ¾ cup granulated white sugar 1 large egg 6 tbsp. butter, melted ¼ tsp. instant coffee granules ¼ tsp. almond extract

2. Whisk together dry ingredients including flour, cocoa, baking soda, salt and cinnamon.

3. Beat the sugar and eggs until fluffy and add melted butter, instant coffee and almond extract. Add the zucchini to the sugar mixture and combine. 4. Add the flour mixture to the wet ingredients in three additions, stirring to combine after each addition. Do not overmix. 5. Pour mixture into prepared baking pan and bake for approximately 50 minutes or until a knife/skewer inserted into the center comes out clean. 6. Remove to a cooking rack and let cool in the pan for 5 minutes. Remove from loaf pan and allow to cool completely.

7. To serve, cut with a serrated bread knife for best results. Enjoy with a hot cup of coffee and feel good about getting your veggies for the day. APRIL 2020

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health

H O M E H E A LT H

Safe At Home: Follow These Tips to Reduce Your Risk of Falls by FirstHealth of the Carolinas

Most people assume retirement is full of vacations, time for hobbies and a home near the coast, but for many, the reality of retirement is quite different.

activities.”

The process can be a winding road. Some folks may still want to work here and there, while others are ready to fully disconnect and enjoy more time with friends and families.

Frequent exercise can improve strength and balance, while a thorough review of medications can ensure that they are having the intended effect and not leading to increased sleepiness or dizziness.

And where they do all of that is key. According to a study from the American Association of Retired Persons (AARP), most people approaching retirement hope to remain in their current residence for as long as they can. Many people feel attached to their homes because they grew up in them or moved to them to raise a family, but that may mean their homes aren’t quite ready for the changes that come with aging. Many seniors are at an increased risk for falls, for example. According to the Centers for Disease Control and Prevention, as many as one out of every four seniors suffers from a fall each year. Many of these falls, as many as 20 percent, result in serious injury including broken bones, hip fractures, head injuries or worse. Many of these falls can cause a serious injury such as broken bones, hip fractures, head injuries or worse. But there are ways to reduce risks, according to Jill Botnick, director of FirstHealth Outpatient Rehabilitation. “We know that falling is not a natural consequence to aging, and that by staying active, you can reduce your risk of falling,” she said. “Once a person falls, they double their risk of falling again. Falling once often causes a person to develop a fear of falling, which can lead to a decrease in physical 32 OutreachNC.com | APRIL 2020

Botnick says staying active is one of the most important ways to reduce risk.

And at home, there are dozens of ways to increase safety. According to the CDC, these are some of the most efficient ways to get your home ready: • Remove tripping hazards like papers, books and shoes from stairways and places you frequently walk • Put small throw rugs away or use tape to keep them from slipping • Arrange furniture to create safe pathways • Keep frequently used items within reach – don’t rely on a step stool • Install grab bars next to and inside your tub or shower and next to toilets • Use non-slip mats in the bathtub and on shower floors • Improve the lighting throughout your home and especially in stairwells • Have handrails put in on both sides of all staircases • Wear shoes whenever possible – avoid slippers If you’re preparing a home for your parents or an elderly loved one, you can also consider in-home screening with a qualified physical therapist. Experts can identify potential risk factors for falling in fewer than 10 minutes. If you are identified as at-risk, you can be referred to a program to help strengthen balance as a way to reduce potential risk. “Talking to your doctor about falling, or the fear of falling, is important,” Botnick said. “They can evaluate your risk factors, and they can also refer you to specialists who can design safe programs that can help reduce risks, improve activity, function and, in the end, independence.” To schedule a screening, please call FirstHealth Outpatient Rehabilitation at (910) 715-2600.

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Bells for Eli by Susan Zurenda “A stunning debut, Bells for Eli establishes Susan Beckham Zurenda as one of the most exciting new voices in Southern fiction,” says Cassandra King Conroy, award-winning and New Bells for EliTell York Times bestselling author of five novels and the memoir A Novel Me a Story: My Life with Pat Conroy. “In this tender, beautifullySusan Beckham Zurenda rendered novel, the powerful connection between cousins Delia and Eli takes them on a journey fraught with longing, desire, and heartbreak. Through loss, Delia comes to understand that the bonds of love can never truly be broken.”

Bells for Eli is a lyrical and tender exploration of the relationship between cousins drawn together through tragedy in a love forbidden by social constraints andAlso a family whose in secrets must available e-book stay hidden. Susan Beckham Zurenda masterfully transports format readers into a small Southern town where quiet, ordinary life becomes extraordinary. In this compelling coming of age story, Susan will be signing copies of her new book culture, family, friends, bullies, and lovers propel two young TITlES OF INTEREST Bells for Eli, people to unite to guard each other in a world where love, hope, “...one of the most exciting new voices in Southern fiction.” on May 5th 5:00 pm at the Country Bookshop and connectedness ultimately triumph.

—Cassandra King Conroy, author of Tell Me a Story 140 NW Broad Street | Southern Pines, NC 28387

First cousins Ellison (Eli) Winfield and Adeline (Delia) Green are meant to grow up happily and innocently across the street from one another amid the supposed wholesome values of small-town Green Branch, South Carolina, in Lightningstruck the 1960s and 70s. But Eli’s tragic accident changes the trajectory of their lives a novel Ashley Mace Havird and of those connected to them. Shunned and even tortured by his peers for Paperback | $16.00t | P540 his disfigurement and frailty, Eli struggles for acceptance in childhood as Delia 978-0-88146-596-9 e-book | $12.00 Whiter Shade of Pale by Procol Harum passionately devotes herself to defending1.him. 978-0-88146-601-0 Delia’s vivid and compassionate narrative voice presents Eli as a confident young man in adolescence—the visible damage to his body gone—but underneath Jean byimpulses. Oliver hide indelible wounds harboring pain and insecurity, scars2. that rule his And while Eli cherishes Delia more than anyone and attempts to protect her from her own troubles, he cares not for protecting himself. It is Delia who has that 3. The Long and Winding Road by The Beatles responsibility, growing more challenging each year. You and i and Bells for Eli is a lyrical and tender exploration of the relationship between Someone Else a novel cousins drawn together through tragedy4. in aLove love forbidden by socialYou constraints (Can Make Happy) by Mercy Anna Schachner and a family whose secrets must stay hidden. Susan Beckham Zurenda masterfully Paperback | $18.00t | P541 978-0-88146-597-6 transports readers into a small Southern town where quiet, ordinary life becomes e-book | $12.00 5. story, I’ll Be There by The Jackson 5 978-0-88146-602-7 extraordinary. In this compelling coming of age culture, family, friends, bullies, and lovers propel two young people to unite to guard each other in a world where love, hope, and connectedness ultimately triumph.

Bells for Eli Playlist:

Mother of rain a novel Karen Spears Zacharias Paperback | $17.00t | P469 978-0-88146-448-1 e-book | $12.00 978-0-88146-450-4

through the needle’s Eye a novel Linda Bledsoe Paperback | $17.00t | P581 978-0-88146-702-4 e-book | $12.00 978-0-88146-703-1

6. The First Time Ever I Saw Your Face by Roberta Flack 7. My Girl by The Temptations cardinal hill

Save My Place

a novel Mary Anna Bryan

a novel Olivia deBelle Byrd

8. Stairway March to Heaven by Led Zeppelin 2020 | fiction 6 x 9 | 282 pp. | Hardback $25.00t | 978-0-88146-737-6 | H988 e-book $12.00 | 978-0-88146-750-5

Paperback | $18.00t | P541 978-0-88146-573-0 e-book | $12.00 978-0-88146-581-5

9. Tubular Bells by Mike Oldfield

OutreachNC.com | APRIL 2020

10. Eli’s Coming by Three Dog Night

Paperback | $15.00t | P493 978-0-88146-501-3 e-book | $12.00 978-0-88146-503-7

Women in Science “Science makes people reach selflessly for truth and objectivity; it teaches people to accept reality, with wonder and admiration, not to mention the deep awe and joy that the natural order of things brings to the true scientist.” Lise Meitner – Austrian-Swedish physicist who discovered nuclear fission of uranium.

“Be less curious about people and more curious about ideas.” Marie Curie, French scientist and the first woman to win the Nobel Prize in two different categories: physics and chemistry.

“Don’t be afraid of hard work. Nothing worthwhile comes easily. Don’t let others discourage you or tell you that you can’t do it. In my day I was told women didn’t go into chemistry. I saw no reason why we couldn’t.” Gertrude B. Elion – American Nobel Prize-winning biochemist and pharmacologist who developed medications to treat leukemia, malaria, meningitis, herpes, and more. “I don’t think that faith, whatever you’re being faithful about, really can be scientifically explained. And I don’t want to explain this whole life business through truth, science. There’s so much mystery. There’s so much awe.” Jane Goodall, English primatologist and anthropologist “If you know you are on the right track, if you have this inner knowledge, then nobody can turn you off...no matter what they say.” Barbara McClintock, cytogeneticist and winner of the 1983 Nobel Prize in Physiology or Medicine “There is only one thing worse than coming home from the lab to a sink full of dirty dishes, and that is not going to the lab at all!” Chien Shiung Wu, Chinese-American physicist who provided the first experimental proof that parity is not conserved in weak subatomic interactions of nuclear beta decay.

“Don’t let anyone rob you of your imagination, your creativity, or your curiosity.” Mae Jemison, physicist and astronaut APRIL 2020

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EHEA

H T L

Telehealth is defined by the American Hospital Association as the ability to connect “patients to vital health care services through videoconferencing, remote monitoring, electronic consults and wireless communications.” The idea behind telehealth is that by increasing access to physicians, specialists and health care professionals, patients receive “the right care, at the right place, at the right time.”

Televisits can be conducted via smartphone or personal computers and are especially effective for less complex visits that do not require in-office appointments

There are, as with any service, pros and cons with telehealth, as well as further research needed and impediments in the way before telehealth becomes mainstream. However, with increased awareness, need and support, the future of telehealth is bright, and understanding how we can benefit from the combination of health care services and technology empowers us all to seek out the best services possible, either here at home or on the other side of a computer screen.

Broadens Horizons

ADVANTAGES

Telemedicine enables physicians and providers to broaden their geographic reach, enabling them to reach and connect with patients who live in rural or distant regions. This is especially helpfully in terms of remote patient monitoring, when patients may be able to visit in person with a provider for an initial appointment but be monitored remotely through telehealth follow-ups. According to Robin Warshaw with the Association of American Medical Colleges (2017), “Physician shortages contribute to many rural health difficulties. Primary care doctors are stretched thin, and specialists, including mental health and substance abuse providers, are a rarity.” Cuts Costs

Financial costs aren’t the only costs associated with doctor’s visits. Patients lose time as well as 36 OutreachNC.com | APRIL 2020 transportation expense when visiting doctors, particularly when traveling long distances. This

can be challenging when patients must take off time from work, must travel from remote regions or must have someone accompany them to an appointment. Chronic conditions requiring frequent appointments can take a toll on patients in terms of financial, physical and mental well-being. Virtual health visits also cut down on late or no-show visits, as patients have fewer constraints on their ability to meet appointment times. Telehealth visits can help mitigate all of these issues and reduce the amount of time and expense of traditional, in-person visits. For doctors, telehealth services can cut costs by streamlining appointment bookings through virtual systems as well as built-in billing systems, dramatically reducing their expenses and the amount of time and money spent sending paper bills via mail. Limits Exposure

With the Coronavirus (COVID-19) in the forefront of the news, exposure to germs and infection in

medical settings is a real concern for many patients, particularly those with compromised immune systems or underlying health conditions. Virtual appointments and follow-ups can help avoid the spread of infectious diseases, like flu and coronavirus, and may be helpful in enabling early diagnosis as patients are more likely to seek care with the first signs of illness as televisits can be more convenient for the reasons discussed above.

DISADVANTAGES

Technology Glitches

With all the beauty and possibility of technology, there are always hiccups and glitches, which can be frustrating in many cases and overwhelming when it comes to our health. Inclement weather, loss of power or software issues can all cause delays with teleservices, and some patients struggle in obtaining strong wireless connections, particularly in the very rural areas providers most need to reach. Also, when adopting telemed services, providers must train staff to become proficient with services, which can be costly and challenging. Computer literacy on the part of the user is also an issue in some cases, particularly when a patient is ill. If technology issues are frustrating or confusing for a patient, traditional office visits may be more viable or having a loved one or caregiver available for support can help bridge the gap. Loss of Personal Connection

Some people, both providers and patients, fear a loss of personal connection while using telehealth services. There is no substitute for human touch and sitting with a person, in person, and getting to know a patient in ‘real life.’ One way to address this is for organizations to properly train physicians, nurses, social workers, clergy and other staff in how to have difficult, personal conversations with patients over virtual platforms. Still, for some, an in-patient visit can never be replaced. Suitability Struggles

Telehealth services and televisits are not suitable for all health-related cases. In many cases, patients will requires tests, swabs, x-rays or other treatments that are impossible to provide virtually. Thus, telemed services cannot fully supplant or replace in-person visits; however, doctors can order tests and follow-up treatments as necessary during virtual appointments.

Obvious advantages in telehealth exist for many patients, particularly patients living in geographically isolated or rural areas. As this field continues to grow, challenges will inevitably need to be overcome, but there is hope that televisits and virtual health might fill gaps, reduce costs and broaden the base of service for many patients as well as providers.

THE RISING COST OF HEALTH CARE 5.5% - the rate at which national health spending is predicted to grow per year through 2027

$3.5 Trillion – the amount the U.S. spent on health expenditures in 2017, more than twice the amount of other developed countries 18% - the percent of U.S. GDP spent on health care

$7 Billion – annual economic value of virtual health 58 million – the number of elderly and disabled persons currently served by Medicare, the largest federal health care program in the U.S. 77 million – the number of expected Medicare beneficiaries by the year 2028

$70 million – the amount provided through the Department of Veterans Affairs in 2017

AROUND THE WORLD:

In other developed countries, spending per GDP on health care is often less than that of the United States. According to World Bank data:

11.54% - FRANCE 11.14% – GERMANY 10.53% – CANADA 10.93% – JAPAN 9.22% – NEW ZEALAND 10.50% – NORWAY 12.25% – SWITZERLAND

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n o i t i l o m e D r o f d e H l m u d u e e s h u M Sc a s a g n i v i r h T w o N t bu

by Ray Linville | Photography by Mollie Tobias

OutreachNC.com | APRIL 2020

Imagine a small, bustling community taking shape in a remote, isolated area and growing with the development of agriculture, naval stores and iron works. That scene is an early picture of what is now Lee County (before it was carved in 1907 from Moore and Chatham counties).

occupied a prominent spot in the community and demonstrates that the city was originally a railroad town. Because the city was named for C.O. Sanford, the chief civil engineer for the railroad, the influence of transportation is clearly important.

Commerce was initially transported over unpaved roads and waterways â&#x20AC;&#x201D; the Cape Fear and Deep rivers. Once coal was mined commercially and added to other products of the local economy, a rail connection was indispensable for further growth.

The well-being of the Railroad House has had its peaks and valleys.

At the junction of two new railroads, the community of Sanford began to take shape in the 1860s, and soon T. W. Tucker arrived to manage the burgeoning rail business. As the first depot agent for the Raleigh and Augusta Air Line Railroad, he and his family became the initial residents of the Railroad House, the oldest house in the city. Built near the depot in the center of town in 1872, two years before Sanford itself was incorporated, the classic Gothic Revival frame cottage has always

Fortunately, today The Railroad House is thriving as a principal component of Depot Park, which has evolved into the cultural and communal center of Sanford where concerts and events are held and families play and enjoy leisure time. However, the stability of the house was not so certain several decades ago. While Tucker and his family lived at the Railroad House, a school for girls was run there by his wife Inder. Because Tucker was also Sanfordâ&#x20AC;&#x2122;s first mayor, the house flourished as a mainstay of community life. However, its importance began to fade. In 1916 the railroad sold the then 44-yearold house, which next became the home for several families before it was used as a tea room.

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OutreachNC.com | APRIL 2020

Because the house had deteriorated, it was scheduled for demolition in 1962. However, interested citizens banded together to save it and formed the Railroad House Historical Association. Through their efforts the house was moved across the street to its current location, restored and given a new life first as the home of the Chamber of Commerce for 30 years and now as the only historical museum of Lee County. “Interesting artifacts are located throughout the house,” says Emily Mierisch, who volunteers regularly at the Railroad House because “I just love history.” With historical photos, objects and documents of the area’s early days, the house is indispensable in preserving local history as itself is being preserved. A historic steam engine, known as Old No. 12, anchors an important part of the landscape near the house. With two small wheels in front and eight large driving wheels, it was placed in service in 1911 and officially retired in 1955. Also part of the park is the passenger depot (circa 1900), a one-story brick structure typical of its period and renovated in 1976. Its charming, wide, overhanging red tile roof with flared eaves almost rivals the artistic architecture of the Railroad House. The house’s central chimney with a recessed lancet panel (inspired by the beauty of cathedral windows) on each face and a crenellated cap adds an antiquated charisma to Sanford’s historic district that encompasses 53 buildings, most dating from 1895 to 1930. The Railroad House’s simple board-and-batten siding is enriched in the front by decorative features such as central double windows, each with a four-over-four sash. Other embellishments include gables on the main roof, two

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dormers and entrance porch that are ornamented with a finial and crossbracing. The interior of the house is finished in simple fashion with wide beaded baseboards and plaster walls. The original floors are mostly intact, and the mantels have a typical nineteenth-century design. The house consists of a one-and-halfstory main block, which has three rooms on the lower level, and a one-story rear wing with its own chimney. This month is the perfect time to visit as is National Train Day, started by Amtrak in 2008 to promote rail travel and recognize the historic role of trains. The day is held on the Saturday closest to May 10, when a 17.6-karat golden spike was pounded in Promontory, Utah, to complete the first U.S. transcontinental railroad in 1869. This year National Train Day is on May 9. Plan a visit soon to the Railroad House and celebrate local and national history, and return again when the sesquicentennial anniversary of the house is celebrated in 2022. The association opens the house, which is listed on the National Register of Historic Places, to the public on Saturdays and Sundays from 1 to 4 p.m. For more information, call 919-776-7479.

OutreachNC.com | APRIL 2020

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e Th shes i W e v i

F 44

OutreachNC.com | APRIL 2020

by Jonathan Scott

Barbara Malley knew her father was dying. She and her mother were with him in his small room, struggling with the inescapable feeling of helplessness. It was simply a matter of time. But in those last, painful few minutes, Barbara had done something that was heroic, even though in the moment it was only a blind act of love. She had invited her sevenyear old son, Paul, into the room. “I remember sitting on the edge of his bed,” Paul Malley now remembers. “We were helping Grandpa Earl drink a soda. I knew there wasn’t anything we could do to make him well or to fix the circumstance. But he always had a big smile on his face when he saw me, and I hoped that being together with him would make him happy. I told him I loved him. “Even at that early age I understood that my presence had been a simple way to affirm my grandfather’s dignity and let him know he wasn’t alone. And I saw that it mattered a lot.” When Malley finished college he came into contact with an attorney named Jim Towey. Towey had worked with Mother Teresa and spent a year living in the hospice she ran in Washington, DC. Deeply affected by his experiences, Towey felt that the legal documents we know as living wills and advance directives weren’t able to encompass the intensely personal side of end of life issues. Towey had founded a non-profit organization called Aging With Dignity, an organization that Malley joined in 1998, and of which he is now President. Of all the activities of Aging With Dignity, the one with the highest profile is certainly The Five Wishes. The Five Wishes is a lengthy but completely accessible document, legal in 42 states, including North Carolina. Any person over 18 can use or edit its pre-written format to express what he or she would like to happen—and how they want to be treated—at the end of life. Comparing a standard living will (dealing with beneficiaries and life-support issues) to The Five Wishes is a little like comparing a mannequin to a live person. The first gets across the basic idea. The second recognizes what it means to be human. Regardless of our professed religious faith, even if none, all of us carry a personal concept of the meaning of life. All of us have an emotional life. And even the most hardened curmudgeon lives in an interconnected web of social relationships. These things are essential throughout our lives and none the less so at the end. But they are usually missing from most standard advance directives. By this time you might be curious what exactly what The Five Wishes are. We can’t reproduce the entire ten page document here, nor can we do it justice in a summary. But here are the “Wishes” themselves along with brief explanations. APRIL 2020

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Wish 1 The Person I Want To Make Health Care Decisions For Me When I Can’t Make Them For Myself This is the basic information in what’s called a Health Care Power of Attorney document. But The Five Wishes allows you to further define, limit, or expand what you want your Health Care Agent to do, including release of your personal information and involvement with your financial and insurance matters.

Wish 3

Wish 2 My Wish For The Kind Of Medical Treatment I Want Or Don’t Want Here you can explain exactly what “life support” means to you — rather than deferring to how it’s legally defined. You can express when and how you want medical treatment to proceed.

My Wish For How Comfortable I Want To Be There’s more to the meaning of “comfortable” than simply pain medicine. Would you like to be read to, even if you are unconscious? How important would your personal appearance at that time?

Wish 5 My Wish For What I Want My Loved Ones To Know This portion includes an area for someone to indicate wishes for a funeral or memorial service. But it also allows someone to speak honestly and directly to those left behind in terms of the emotional and spiritual issues we all have, even those whose issues might not fit the common definition of spiritual. 46

OutreachNC.com | APRIL 2020

Wish 4 My Wish For How I Want People To Treat Me Some of us might want clergy—or possibly member of our faith community—to be with us. Others might prefer just family intimacy or to spare the family entirely. Many people wish they could spend their final hours at home.

It wasn’t very long ago that a woman (whom I’ll call Ella) came to the emergency room of one of our local hospitals complaining of shortness of breath. Quickly her condition began to deteriorate and, in the midst of her crisis, Ella gave the hospital permission to put her on a ventilator. That, sadly, was the last decision she ever made for herself. Ella had a close companion for years, but the couple had never married. That meant his input wasn’t legally acceptable. Instead, the hospital reached out to Ella’s children from whom she had been estranged. Confused by a landslide of feelings, the children had nothing on which to base making life and death decisions. Their natural sense of undirected compassion led them to take the least guilt-provoking attitude they could, which was to keep Ella alive at all costs. Unfortunately, Ella was being consumed by cancer. She suffered through long and difficult procedures and endured a great deal of pain, all the while unconscious and unable to communicate. “I would never want to put someone in the position of making those decisions for me,” says nurse Jennifer Reid. Reid worked in the hospital when Ella was being treated. “I think she suffered unnecessarily. It was all very hard on the family since they had nothing to go on, nothing to tell them what Ella would have wanted. Because they had been estranged, they wanted more time with their mother. But I don’t know how much they were thinking of themselves and not the woman lying in bed in pain.” Reid might be considered the archetypical product of Moore County. She went to school on a golf scholarship and later returned here to sell real estate. But when the father of her husband, Todd, was diagnosed with Stage 4 lung cancer, something remarkable happened. “The hospice nurse who cared for him changed my life,” Reid says. “I knew that’s what I wanted to do. When I got home I told my husband I wanted to start volunteering with hospice. He said, ‘Just go back to school and become a nurse.’” So, at the age of 33, 12 years out of college, raising two boys, and all the while working, Reid went for, and achieved, her BS in Nursing. “I worked critical care at Reid Heart Center (FirstHealth in Pinehurst) for two years, then for six months at Liberty Hospice as a case manager. I wound up crying a lot. That kind of work is emotional all the time. I couldn’t help taking my work home. So I went back to critical care, but I wanted to bring what I had learned as a hospice nurse to the hospital bedside.” A self-professed life-long learner, Reid is currently enrolled in the Adult Gerontology Nurse Practitioner program through UNC-Greensboro. Her doctoral project, which will be completed in May 2020, is in End Of Life Planning. It was her initial research into the subject brought her head long into, of course, The Five Wishes.

The Five Wishes is about ten pages long plus cover. It includes a short, cut-out form that can be filled out and kept in a wallet to identify the owner as having completed the entire document and gives its location. It’s unavoidably true that none of us can know when it might be needed. To explore more of the scope of The Five Wishes and to purchase copies, visit www. fivewishes.org. Even though Nurse Jennifer Reid is currently busy working to complete her doctorate, she invites anyone who would like to know more to send her an email at jentreid@gmail.com. APRIL 2020

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“It’s written to be easy to understand,” says Reid. “And it’s simple to change. You can scratch through parts or add pages. I’ve seen people take the basic document and get really creative with it. When you’re done, you get it notarized and it’s a legal document.” Last fall, Reid gave a presentation on The Five Wishes at the Moore County Senior Enrichment Center. Even as a strong proponent of the document, she was impressed at the response she received. “The audience was really engaged,” she says. “They asked great questions. It showed they understood how important all this is.” According to research Reid has done for her doctorate, over three-quarters of Americans will have no part of decision making when they are the end of their lives. When Reid talks about this issue, she does so with the passion of a hospice case worker who couldn’t stop crying. But she also speaks with authority of an experienced healthcare provider. “Forty percent of patients in our hospital at this moment,” she says, emotion clearly in her voice, “aren’t able to say what they want to be done with them.” Paul Malley, the President of Aging With Dignity, lives with another memory of the end of life. When his grandmother was coming to her last days, Malley was in high school. On a weekly basis he visited her in the skilled nursing facility. “I knew she talked about her feet always feeling hot. Apparently well-meaning caregivers would bundle her up tightly and tuck her feet under the covers. So the first thing I would do was untuck her so her feet could stick out. That would give her a big smile. It might sound simple or hokey or meaningless, but I think it meant a lot to her— that I knew what she wanted. “The most important thing for us at Aging With Dignity,” says Malley, “is for people to understand that, even though this is a difficult awkward conversation to bring up, it doesn’t have to be difficult. The Five Wishes is there so someone can have this important discussion with their family and document it. Our hope is that each person becomes the champion in their own story.” “The time to fill out The Five Wishes is when you’re healthy,” says Jennifer Reid. She has seen it time and time again. “When patients have an advance directive, things go so much better. It can be beautiful. It’s the way God intended death to be.”

OutreachNC.com | APRIL 2020

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E C H L T O K C C K a v n d A A ces in ng Skin c -Agi a r e by Crissy Neville

OutreachNC.com | APRIL 2020

Cell phones. Laptops. Smartwatches. Google Home. What’s on your tech bucket list? With technology’s arm reaching into every nook and cranny of our lives from communication to security, why not into health and beauty, too? Innovative trends in modern skincare afford many choices for men and women looking for alternatives to the traditional cleanser and moisturizer anti-aging regime. Many things affect how your skin ages including your genes, daily habits and the environment. First things first: stay out of the sun. The sun is your enemy when it comes to keeping skin looking younger longer. According to data from the Department of Applied Research and Development from L’Oréal of Paris, a leading total beauty care company, 80% of skin aging comes from the effects of the sun, not to mention skin cancer. The American Academy of Dermatologists concurs. “Ultraviolet radiation from the sun and indoor tanning beds not only can increase your risk of skin cancer but also can contribute to skin aging,” said board-certified dermatologist Arianne Shadi Kourosh, M.D., MPH, FAAD, director of community health and co-director of the multiethnic skin clinic in the department of dermatology at Massachusetts General Hospital in Boston. “Although there have been some impressive strides in anti-aging treatments, no one product or procedure can completely reverse the long-term effects of poor skincare decisions, and protective measures are the cornerstone of good skincare,” Dr. Kourosh says. “The best sunscreen for each person will depend on many factors, including genetic makeup, environment and lifestyle considerations. A board-certified dermatologist can evaluate the unique needs of your skin and help you develop an appropriate sun protection plan.”

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Traditional Approaches So, what’s one to do? You know the drill. Do not sunbathe or visit tanning salons. Limit sun exposure, especially between the hours of 10 a.m. and 2 p.m. Wear protective clothing such as a hat with a 2-inch brim, long-sleeved shirts, and sunglasses with UV 400 or blocker lenses. Put on sunscreen before going out to protect your skin from UV light and reapply sunscreen every 80 minutes to two hours, even more often if you are swimming or sweating. Use broad-spectrum products SPF 30 or higher that provide both UVB and UVA protection. To achieve a desired sun-kissed look, try self-tanning products instead. Traditional noninvasive treatments for early signs of aging include products containing retinoids, vitamin C and hydroxy acids. For moderate and severe facial sun damage evidenced by wrinkled or sagging skin and dark age spots, chemical peels, dermabrasion, ultrasound energy devices or modest non-invasive tightening and lifting accomplished through ultrasound, laser treatments and radiofrequency are options. Minimally invasive skin tightening techniques also use radiofrequency, but laser resurfacing gets the best results. Deeper facial lines require more serious treatments such as botulinum toxin, i.e., BOTOX, other fillers including hyaluronic acid injections, your fat, and Gore-Tex implants, porous synthetic materials commonly used for nasal augmentation. Some decide to go the route of surgery for longer-lasting results and have facelifts, brow lifts, and cosmetic surgery on the eyelids. Face-lifts in past years only tightened the skin, but now the procedure achieves more by repositioning muscle, skin and fat. Persons with good skin elasticity despite facial aging make the best candidates for this invasive operation. More minor procedures often fit the bill if a face-lift is not yet needed. A forehead lift corrects sagging in the skin, upper eyelid and eyebrows, while eyelid surgery reduces bagginess from lower eyelids and removes excess skin from the upper.

OutreachNC.com | APRIL 2020

Modern Innovations Technology and anti-aging amalgams flooded the market last year, bringing dermatology to the door of consumers looking to turn back the clock. Tech innovation seems to have snuck past the doorbell cam and made a beeline straight for the consumer bathroom, as well the local dermatologist’s office. An App for That Skin scanners are a modern technology that allow dermatologists, skin therapists and thanks to at-home models, everyday consumers to analyze the state of the skin on a deeper level. Glancing in the mirror only shows what is happening on the outer layers of the skin, and this in-depth probe helps target problem areas to determine a course of action and customized treatment best. Some models convert your smartphone into a scanner via a magnifying mirror attachment and corresponding productrecommending app, resulting in customized printable micro 3-D face masks to target specific needs. Let There be Light LED light therapy is another technology with multiple benefits. The painless, noninvasive practice stimulates collages to help regenerate the skin from aging. Skincare practitioners use red or blue light frequencies based on the area of concern: red is primarily used for anti-aging, while blue treats acne. In-office treatments will take up to 10 weeks for the best results, while at-home LED devices offer convenience but usually less dramatic results. All Frills Facials Who doesn’t love the luxury of a soothing facial? Increasingly gender-neutral, facials are a simple starting point for a new skincare regime enjoyed in spas and homes alike. Upping the game, the nonirritating HydraFacial™ innovation is the newest advance in non-laser, in-office skin resurfacing and is so popular that reports show that one is performed around the world every 15 seconds. Also known as the “vampire facial,” platelet-rich plasma facials have received much attention in recent years. This in-office method involves the drawing of platelet-rich blood from one’s arm and the reinjection of it into the face or scalp, often supplemented with fillers. According to the AAD, some patients and dermatologists find that PRP can reduce wrinkles, plump up sagging skin, get rid of deep creases, improve complexion and diminish acne scars, with little to no recovery downtime and results that can last up to 18 months. Often requiring three or more treatments, the dangers include the handling of blood, and of course, like everything else, there are no guarantees.

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No Pain, No Gain Yet another dermatological technique akin to acupuncture is microneedling. The collagen induction therapy - microneedling, dermarolling, or skin needling - is a cosmetic procedure that involves repeatedly puncturing the skin with tiny, sterile needles. Here, skin care professionals use multiple tiny, sterile needles to cause physical trauma, prompting the derma, a deeper layer of skin, to rebuild. Used to reduce in the appearance of large pores, fine lines and wrinkles, scars, and stretch marks, microneedling is an in-office and at-home process. Home microneedling or dermarolling is widely accessible and more comfortable than the professional version as the needles do not puncture the skin, thereby altering the results. Call Me Maybe Waiting in the doctor’s office is just the worst, but thanks to the latest model of consultation – teledermatology – patients can use their smartphones to share files and improve the way dermatologists diagnose treat skin conditions. With this technology, patients can upload photos of their skin problems and receive feedback and assistance from their dermatologists. Not all offices offer this service, but it is another growing trend in dermatological care.

While the advancements in technology still have much room for growth, dermatologists recognize the potential of cutting-edge advancements for their far-reaching effects in both skincare and health care. With such innovations, dermatology is putting its best face forward to patients and medicine alike.

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WHAT WE NEED TO REMEMBER ABOUT

s ’ r e m i e Alzh a i t n e m e D & by Jonathan Scott

“People are so afraid of getting this diagnosis,” says the attractive young RN. “There’s been such a terrible stigma put on it. When you get a diagnosis of cancer, you can treat it. You can beat it. But you can’t beat Alzheimer’s. It’s never going to get better. Eventually it’s going to take away the person you love.” Heather Hodge is speaking from the heart of a daughter whose mother was diagnosed at the age of 63 with the early-onset form of the disease. That was five years ago. Heather and her sister recognized the signs long before the official diagnosis was made. “I remember asking her why she always carried a thesaurus.” “Oh, sometimes I just forget words,” her mother said.

Then there was the time when Heather’s mother complained that someone had put all the towels into the washing machine. It was neither Heather nor her husband. Mom had forgotten what she had just done. It was a matter of years before a brain scan confirmed it. “I would get on the phone with my sister and we would cry together. Sometimes we couldn’t stop crying.” Heather knows that the loss isn’t just theirs. “What’s hardest,” she says, “is when my dad gets emotional. He and my mom had wonderful dreams of what they would do in retirement. They first met when they were both hunting. They loved the outdoors. They were going to get a Fifth Wheel RV and explore.” She pauses. “That’s not an option anymore.”

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Coury O’Donoghue is the Director of Program Services of the Alzheimer’s Association, Western Carolina Chapter. “The reality we’re looking at is that, without intervention and without the progress of research, the number of Americans afflicted with Alzheimer’s disease is likely to rise to 14 million by 2050.” In her job, Coury works with what she calls “an army of volunteers” to help educate the wider general public about what we should all know about Alzheimer’s and dementia. She, herself, knows. It’s from a background working in long-term care and, maybe most compelling of all, from personal tragedy. Her great-aunt suffered from a condition called vascular dementia.

“If we had known what we know now, we would have been able to care for her very differently.” What Coury wants us to take away from her story is that we keep in mind how far medical science has come—and how far it is hoping to go—in dealing with what many describe as an epidemic, some as a looming tsunami, and everyone as a heartbreak. “Thanks to monumental federal funding of the National Institute of Health in the last several years, more research can be supported,” she says. But she’s also quick to credit her own organization, the Alzheimer’s Association. “We’re one of the largest non-profit funders of research globally.” Currently, the Association is investing $167 million in 27 countries. They boast that their grants have funded some of the most instrumental research in Alzheimer’s science.

OutreachNC.com | APRIL 2020

“We’re campaigning for better avenues for earlier detection.

Ten years ago we could never have conceived of having a blood test to detect signs of Alzheimer’s. Now that’s in sight. But we’re also looking at prevention and minimizing risks.” At the end of 2019, the Association published a progress report giving a snapshot of where medical research is now and hints to what might be next. The results at this early stage suggest healthy lifestyle choices in diet, exercise, and mental stimulation might help, as might keeping blood pressure in check. There are other indications that accord with what we intuitively expect: isolation resulting from hearing and/or vision loss seems to increase chances of cognitive decline. But it’s only natural that most of us want a magic bullet—a pill that can reverse or, at least, stop the progression of dementia. One of the largest obstacles to that—one that’s monumental—is that science doesn’t know precisely what goes wrong in the brain of someone with Alzheimer’s, let alone precisely what can be done about it.

The Alzheimer’s Association wants us to know that the disease is not a normal part of aging. They use a compelling analogy of a factory to describe what happens in the brain. “Backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes in the brain.” Many of us have heard about something called betaamyloid, a substance that seems to clog up the brain. Then there’s tau, tangles that form inside brain cells. Right now Duke Health has a few medicines in its arsenal, memantine and cholinesterase inhibitors, which may keep memory symptoms under control and slow

the progression of symptoms in people with moderate to severe Alzheimer’s. But, as in most of the scientific literature on dementia today, the word may is usually used to keep the optimism cautious.

The hard truth is it doesn’t appear that one single problem causes this disease and no single treatment will ever do the trick. That’s why the Alzheimer’s Association’s report for 2019 concludes with the hopeful news that there are 500 new potential drugs in developmental stages. Because a truly effective and safe medication for Alzheimer’s would be an unimaginable gold mine for a pharmaceutical company, the best and brightest minds have been put to work on the challenge. As encouraging as it sounds, that type of promise unfortunately offers no benefit to Sandy Garratt, who isn’t able to wait for the future. She is a full-time caregiver for her mother, Leona Pelkey. Leona, 91, has been suffering from the progressively crippling effects of dementia for 13 years. Despite that, she is still a strikingly beautiful woman with blue eyes that shine. When her mother’s issues became more than she could handle, Sandy placed Leona into, first one, then a second, local memory care facility. Last year, Sandy brought her back to their Pinehurst home to live with her and her husband. Sandy, with a telling sense of humor, compares her life now to the movie Groundhog Day. “I do the same routine, say the same words that comfort and encourage her, watch the Hallmark Channel and The Golden Girls. As a caregiver, I try to change that sameness up a little each day with different type of music or a different sandwich, read her a story or we look at a photo album. It helps make ‘Groundhog Day’ not quite so redundant and gives a fun element to both me and my mom.” If we, as caregivers or potential caregivers of a loved one with Alzheimer’s or dementia (aren’t we are all potential caregivers?) want to do what we can in the face of a

horrific, rising epidemic, we should learn from Sandy Garratt’s story. “When we made the decision last June to bring my mom back home,” she says, “I took four months to prepare.” When Heather Hodge, the young RN we met at the beginning of this story, says, “It’s not going to get better,” she’s referring to the inexorable physical progression of a brain disease. She doesn’t mean that there isn’t anything we can do to make things better for ourselves or our loved ones in the face of Alzheimer’s or dementia, regardless of the stage of the disease. The truth is, we can do plenty. Sandy is eager to share her journey of preparation. That preparation costs mainly time, and the investment has paid for itself many times over. Reading, watching, attending, and especially calling the right resources provided her a sense of empowerment in a situation that seemed completely disempowering. Every county in our area has its own resources, so people dealing with Alzheimer’s and dementia may have to adapt some of Sandy’s story to their own location. Being in Moore County, Sandy Garratt’s first step to prepare led her to Yarona Thomas, Family Caregiver Advisor for the County Department of Aging. “I can’t say enough good things about Yarona. She is amazing. She gave me all their information on local services for caregivers with homebound loved ones with dementia.” From her office at the Moore County Senior Enrichment Center, Yarona is able to guide families to available resources ranging from county-funded respite care to in-home aides (currently a wait list in Moore County), to the Alzheimer’s Association free 24/7 hotline. “The Alzheimer’s Association is wonderful,” says Yarona. “They keep me educated on all the latest research on future treatments and what’s available for families. They also make themselves easily accessible.”

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Day after day, Yarona is confronted with the frustration, the hopelessness and sometimes panic of families forced into a life of seeing a loved one being taken away by dementia. But her professional experience has brought her to the exact same place that Sandy Garratt’s family experience as led her. “You don’t ever want to feel abandoned,” says Sandy. “Remember that you don’t have to be alone in this. Help is around.” Yarona’s face brightens when she mentions the Alzheimer’s Association 24/7 hotline. “It’s there for people to call about any issues, including how to deal with a crisis. You can call them in the middle of the night saying you don’t know what to do about your parent.

You’re not alone,” she says, echoing Sandy. “And it doesn’t get any better than that.” The Alzheimer’s Association 24/7 hotline is 800-272-3900. They welcome your call. We are not alone in this.

RESOURCES The following is a list of some of the other resources Sandy Garratt found valuable: Duke Dementia Family Support Program. Free support groups and events. (Natalie Leary 919-660-7542)

AOS and Friends Care provides direct care grant funds to be used toward respite care as well as music players and robo-pets. (910-585-6757 or info@aosfcare.org) Dr. Robert Deucher of St. Luke’s Medical Practice in Carthage, NC. Dr. Deucher makes house calls to Sandy’s mother. (910-725-0809) FirstHealth Palliative Care and Hospice. An RN comes weekly to assess Sandy’s mother. (910-715-6000) Dementia Alliance of North Carolina. Provides a one-time reimbursement for caregiver assistance. (800-228-8738) Videos by Teepa Snow on how to care for someone with dementia in your home. “Until There’s a Cure for Dementia...There’s a Positive Approach to Care!” teepasnow.com Local home care agencies. (eg. Aging Outreach Services at 910-692-0683) Facebook. Social media helped Sandy and mom find ways their family members could help from far away by sharing pictures, stories, and videos. 60

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GREY MATTER

See Grey Matter Puzzle Answers on Page 65

ACROSS

1. Canadian law enforcers 5. Actor Idris 9. Cut or bruise 11. Vegetables 13. Aircraft delivery 15. To make obsolete 16. Things similar to those already noted 17. Columbus is a famous one 19. Age group 21. Denotes nature of sound 22. Klutz 23. Uninteresting 25. Computer manufacturer 26. 2,000 lbs. 27. Genus of seabirds 29. Emerges 31. Baseball stat 33. Witnesses

34. Observed 36. Satisfy 38. Former OSS 39. Small Eurasian deer 41. Wife of Spartaâ&#x20AC;&#x2122;s king 43. Ballplayer accessory 44. Temporary cessation of breathing 46. Where construction workers ply their trade 48. Arguments that justify a religious doctrine 52. Thick cloud of tiny water droplets 53. Widens 54. Detection 56. Period of inactivity 57. Tomato and vodka are two 58. Greek war god 59. Urinates

DOWN

1. Churned 2. Seal bottles 3. Million barrels per day (abbr.) 4. Meat from a pig (French) 5. Within 6. Walk in a slow pace 7. Cries 8. About Andes 9. Fishermen use it 10. Expresses delight 11. Shouts 12. Feudal agricultural laborer 14. Sailboat 15. Small Eurasian willows 18. S. American native people 20. Extreme disgust 24. Nonsense (slang) 26. Produce male reproductive cells 28. Computes 30. Pop singer 32. Weds secretly 34. Having two poles 35. Yankee hero Bucky 37. Building 38. Per __, each 40. Six (Spanish) 42. Makes amends 43. Scoundrels 45. Baseballâ&#x20AC;&#x2122;s best pitchers 47. Some are scrambled 49. Emit coherent radiation 50. Singer Redding 51. Break 55. Institute legal proceedings against

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Guess Who?

I am a comic actress born in Texas on April 26, 1933. I once lived in a boarding house for women pursuing careers in acting. I have earned a Tony, Emmy and Golden Globe for my work in various genres.

ANECDOTE ANTHROPOMORPHISM ARCHITECTURE ARTWORK CANON CHARACTER CLASSICAL

COMMUNICATION CREATIVITY EPITHET ETYMOLOGY EVOLUTION HIERARCHY HUBRIS

FUN FACTS The Full Pink Moon: The Biggest & Brightest Supermoon of 2020 April’s full Pink Moon will rise on the night of Tuesday, April 7, reaching peak illumination at 10:35 P.M. ET. This full Moon, which is the first full Moon of the spring season, is both a supermoon and the Paschal Full Moon!

INNOVATIVE LEXICON LITERATURE MORES MUSICAL OPINIONS PARADOX

“Just for Fun” Holidays April 1: Sweet Potato Day April 6: International Pillow Fight Day April 7: National No Housework Day April 17: Blah, Blah, Blah Day April 21: Go Fly a Kite Day April 26: National Richter Scale Day April 27: National Sense of Smell Day

PERFORMANCE PHILOSOPHY REASONING RECORDS RENAISSANCE RHETORICAPRIL 2020 SATIRE

TEXTS THEATER THOUGHTFUL THOUGHTS TRAGEDY OutreachNC.com 63 VIRTUE

life

OVER MY SHOULDER

Lights in the Attic by Ann Robson

After recently reading for the 100th time Shel Silverstein’s “Light in the Attic,” I casually looked into the eyes of my lap cat and wondered out loud if indeed there was a light in her attic and was she looking out at me? Our animals appear to know us better than we sometimes know ourselves. As I stared at Sugar, our three-years-old tabby, the fourth in a series of tabbies we’ve owned, I wanted to know what she was thinking. I constructed a scenario in which she, and our other cats, told us what they were thinking. Charlie, our first cat and the only male, had some interesting qualities. He arrived on our doorstep in Oswego, NY, and hung around until we gave him water, then food. He considered himself a great protector. “Why did you bring me a dead fish, Charlie, and put it on the front step? You shocked me!” “Well, when that man of yours went away on business again I had to make sure you had food. And, why did you ask your young daughter to throw it into the river? That was a special present from me to you.” “I’m sorry, Charlie, I appreciate what you did but no more, OK?” “Why not?” he me-owed as he sulked away. A few years later, “Oh, Charlie! Why did you try to cross the road?” “Why not?” he said as he slipped away from us.

OutreachNC.com | APRIL 2020

Some years later, Boots, a female tabby, came to us in the middle of a cold and stormy night. She could have been Charlie’s twin. “Where have you come from?” I asked. “Where do you think? I followed my nose and decided to try my luck someplace where I could get warm and dry. OK?” She quickly became part of our life. She was an indoor/ outdoor girl. She brought us fleas which loved our shag carpet. “Why do you do this to us?” “You? Imagine how I feel. You forgot my flea medicine again!” “Wait a minute, what’s going on here? Why are strange men packing up all our stuff and putting it in a large van? What does ‘moving’ mean? I’m not going. You won’t leave me here alone, will you?” “Of course not, Boots, you’re coming with us to a new home in Cleveland.” “Isn’t that the place where the river burned?” I’m definitely not staying ….oh, this place isn’t so bad. I love the loft where I can sleep but I miss the woods. Guess I’ll stay. My food bowl and water dish are here. So’s my litter box. OK, you win this time.” “What? Another moving van? We’ve only been here two years. You people need to stop doing this. I’m definitely not going this time.” “Wellll, maybe I’ll stay. Kentucky is warmer. You did bring my stuff. I can play in the screened porch. I’m getting older so maybe I’ll take it easy.” “That’s a good girl.” Not long after this move, Boots became ill and for weeks

GREY MATTER ANSWERS she ate very little. She had cancer and treatment sounded dreadful for a loving animal so Kentucky became her permanent resting place. “Goodbye, Boots. There’ll be no more like you. Thanks for the memories.”

CROSSWORD

On my 50th birthday a young, scrawny battered version of Boots showed up at my surprise party. Nope! Not having her! One lonely night a few weeks later, after I’d been putting water and food out for her, she appeared at my kitchen window. “OK, you can come in.” “Thank you, thank you,” she purred. I named her “5-0” and she was with us for almost 20 years moving to Kingston, Ontario, then Detroit and finally to North Carolina. When she became ill with seizures, I held her in a soft towel and talked to her about where we’d been and what we’d done. “I had a ball,” she seemed to say. “And thanks for the memories.”

WORD SEARCH

After several catless years, we fell for another stray we named Sugar. She’s the one I talk to most. I usually ask her “How’s your day going?” “Just fine; you gave me my morning treats, Dad took care of my litter box and gave me food and water. I sleep anywhere I want. I chase birds from window to window. Why can’t I catch them? “You do realize that dogs have masters but we cats have servants, don’t you? I like my treats on time in a special place. I don’t like some flavors of cat food so don’t bother. I do like soft laps, comfy beds, and some people who come to visit. Got that?” “Yup, anything you say, ma’am.”

SUDOKU

Ann Robson is the author of “Over My Shoulder: Tales of Life and Death and Everything In Between.” She may be reached at overmyshoulder@charter.net .

GUESS WHO? CAROL BURNETT APRIL 2020

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photo of the month

Swift moving clouds under a starlit night sky captured on the Sandhills Game Land. 66

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by Brady Beck

ASSIGNMENT

Interview a Veteran!

SECOND ANNUAL INTERVIEW A VETERAN CONTEST Open to all students between the ages of 5 and 18. Interview a Veteran about the lessons learned during his/her military service.

• submit in interview form format including the questions posed and the answers given • include a brief description of how the interviewer knows the Veteran • provide a brief background of the Veteran’s service • maximum of 1000 words in length

Three Prizes:

One winner from each age group (elementary, middle & high school) will receive a $100 gift card. The winning interviews will be published in the November ONC issue. 2nd and 3rd Place interviews will be published online.

September 1, 2020 deadline Interviews should be emailed to: Amy Phariss, Editor in Chief - OutreachNC Magazine APRIL 2020 OutreachNC.com 67 editor@outreachnc.com

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