COMPLIMENTARY
AUGUST 2018 | VOL. 9, ISSUE 8
Living Healthy Serving the Sandhills & Southern Piedmont
AUGUST OutreachNC.com 1 | OUTR E A C H2018 N C |. C OM
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fundraiser event All funds raised will go toward AOS & Friends Care direct care recipient requests, programs and community education/ awareness efforts targeting older adults, with an emphasis on Alzheimer’s and Dementia.
For your donation of $25, we will purchase a mum in honor or memory of your loved one or local care facility
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Mail completed form with checks payable to AOS & Friends Care: 230 North Bennett St | Suite 2 | Southern Pines, NC 28387 ALL DONATIONS ARE TAX-DEDUCTIBLE.
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THURSDAY, SEPT. 20 | 3:30-5:30 P.M. 676 NW Broad Street | Southern AUGUST 2018Pines | OutreachNC.com LIGHT HORS D’OEUVRES | MUSIC | WINE & BEER
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24 Dream Sleep: Science & Mystery
by Jennifer Webster
28 Birding in NC: Dunn-Erwin Trail
by Ray Linville
34 Carolina Conversations: The Importance of the Right Fitness Equipment
by Corbie Hill
42 Life After Fear
by Corbie Hill
46 Surviving & Thriving
by Corbie Hill
52 Medicare: What You Need to Know
by Richard King
features AUGUST 2018
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OutreachNC.com | AUGUST 2018
Living Healthy Issue
AUGUST 2018 |
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departments August 2018
14
advice & health
“The first wealth is health”—RALPH WALDO EMERSON
18
16 life
10 Ask the Expert
14 Cooking Simple
12 Brain Health
18 The Reader’s Nook
16 Tech Savvy
20 Pursuit of Memory
19 Home Staging
62 Grey Matter Games
by Penny Lachance, LCSW-A
by Karen D. Sullivan, PhD, ABPP
by GCFLearnFree.org by Kasia McDaniel
22 Triumphant Elder
by Tim Keim, EYT 500
23
Role Reversal by David Hibbard
by Ray Linville
by Michelle Goetzl
by LuEllen Huntley
Sudoku, Word Search & Crossword Puzzles
66 Generations
by Corbie Hill & Michelle Goetzl
51 Resource Marketplace
LOOKING AHEAD TO UPCOMING ISSUES SEPTEMBER
“Generations” ✴The Robeson Planetarium and Science Center ✴Lessons from our grandparents
Find the resources you need.
OCTOBER
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Cover Image by Mollie Tobias
“The Long Game” ✴Decluttering ✴Out-of-pocket healthcare costs
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from the editor
I don’t know how to feel about this issue of OutreachNC. On the one hand, it’s a special issue. Our theme for August is “Living Healthy,” so this month we’re sharing tips on choosing the right exercise equipment courtesy of the nice folks at May Street Bicycles, River Jack Outdoor Trading Co. and RIOT (Run in Our Tribe). We’re running our first story by LuEllen Huntley, who writes with tenderness and honesty about maintaining a relationship with her mother, who presents symptoms of Alzheimer’s dementia. Jennifer Webster explores sleep and dreams, but also the causes of sleep apnea, while intrepid friend-of-the-magazine Ray Linville takes us birding once again. Check out the owl photography Brady Beck contributed to that story – it’s phenomenal.
On the other hand – and for reasons that can’t be helped – it’s a tough issue. See, August marks one year since I was diagnosed with chronic lymphocytic leukemia. If you met me on the street, you wouldn’t know that I have cancer. In fact, there are people I have worked with since February, when I started with OutreachNC, who had no idea I’m sick (and who I had to tell in person before this issue ran. That’d be a hell of a way to find out about a friend’s cancer...). See, I’m not compelled to tell people about my diagnosis. If it comes up naturally in conversation, sure, I’m open about what I have, and I really don’t mind talking about it. By its very nature, the “I have cancer” conversation is a heavy one, though, so if it doesn’t come up, I don’t force it. I do, however, feel it’s necessary to write about my leukemia. For one thing, I’m a writer. It’s not merely my job, but also a major part of my personality. Writing is how I process the world. I can think of few things in my life so far as monolithic and terrifying as my cancer. I’ll be processing it for a long time – or at least I hope so! For another, I’m far from alone. I remember going to my first few oncologist appointments and looking around the waiting room. My fellow survivors, I noticed early on, came from all backgrounds and all walks of life, and were of all ages. One of them, Sherri Eder, works for the magazine’s parent company, and she was happy to share her survivor’s journey for this issue as well. The final point I want to share is that cancer hasn’t stopped me – not yet, anyway – and that I’ll be living and thriving as long as I physically can. The way I see it, I go through what you go through – or what someone close to you has gone through – and it’s my responsibility as a writer to tell the truest story that I can. If it’s helpful, I’ve done my job. Thank you for picking up OutreachNC, and I’ll see you in September.
- Corbie Hill
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Editor-in-Chief Corbie Hill | Editor@OutreachNC.com Creative Director Kim Gilley | The Village Printers Creative & Graphic Designer Sarah McElroy | The Village Printers
Monthly Musings from the Meowing Maestro
Ad Designers Stephanie Budd, Cyndi Fifield, Sarah McElroy Proofreaders Ashley Eder, Kate Pomplun Photography Brady Beck, Diana Matthews, Mollie Tobias Contributors Michelle Goetzl, David Hibbard, Corbie Hill, LuEllen Huntley, Tim Keim, Richard King, Penny Lachance, Ray Linville, Kasia McDaniel, Ann Robson, Rachel Stewart, Karen Sullivan, Jennifer Webster
“I need a vacation.”
Spiritual Advisor Jeeves
Y Publisher Amy Natt | AmyN@AgingOutreachServices.com Marketing & Public Relations Director Susan McKenzie | SusanM@AgingOutreachServices.com Advertising info@outreachnc.com 910-692-0683 Circulation 910-692-0683 | info@OutreachNC.com
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OutreachNC PO Box 2478 | 676 NW Broad Street Southern Pines, NC 28388 910-692-9609 Office | 910-695-0766 Fax info@OutreachNC.com
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OutreachNC is a publication of 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.
“Go ahead, rub my belly. I dare you. There’s a 50% chance I’ll bite, but hey! Live dangerously.” AUGUST 2018 |
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advice
Our Aging Life Care ProfessionalsTM will answer any aging questions you may have.
Email us your questions! ASK THE EXPERT
info@OutreachNC.com
Independent Living Versus Assisted Living: Which is a better fit? by Penny Lachance, LCSW-A
My wife and I have found maintaining our home to be increasingly difficult and costly. We are considering downsizing and potentially moving to a senior community, but we are a bit overwhelmed and confused. Particularly, we have seen some options that list themselves as independent or assisted living. My wife and I get around all right, but we could use some help with things like cooking and cleaning. Which would be the best fit for us?
As I am sure you have observed in your research, the variety of senior living communities can be vast. By the sounds of it, you and your wife are on the right track narrowing your search to independent and assisted living. There are some questions you can ask yourselves to further narrow the search and make the selection that fits you best.
your policy for any coverage of AL costs. Government special assistance is also available for those who have an income of less than $1200/mo. IL is typically less costly than AL, but because of the great variance in IL arrangements, IL has the potential of costing more.
3. What if I suddenly need more care? It seems that you and your wife are already having honest discussions about needing extra help- that’s 1. What level of care is currently needed? great! An important question to discuss is what both As I understand from your question, you and your wife your expectations are if there is a decline in cognition or are both capable of all activities of daily living (ADLs) physical abilities. As long as you are able to supplement such as bathing, dressing and feeding yourself. However, the services provided by AL or IL to meet your changing tasks such as yardwork, cleaning and cooking are either needs, whether that be with private caregivers or family being paid for through a service or are being personally members, you will likely be able to stay in your residence. managed. Independent living (IL) communities vary in However, looking into a senior community that has what services they offer, as there are no state or federal multiple levels of care (sometimes known as Continuing regulations on what must be available. You will find that Care Retirement Communities) can provide peace of most provide a minimum of care for the yard, but many mind that you will be able to stay within a community also have meals and cleaning services provided. Make sure prepared to adjust to your needs. you request a full list of services included in the cost of Choosing to relocate to IL or AL is a decision to relieve any IL you are interested. If you or your wife are needing some of the personal burden in daily tasks. Not only any extra assistance with the ADLs mentioned earlier or that, but it provides new opportunities for activity and struggle to remember when and which medications to socialization that can make the transition both exciting take, you may want to take a closer look at assisted living and positive! I wish you the best of luck! (AL). 2. How do I plan on paying? There is a common misconception regarding financial assistance for IL and AL that Medicare will aid with the cost. Unfortunately, that is not the case. In fact, IL is always a private pay arrangement. If you have a long-term care (LTC) insurance or VA benefits, be sure to review
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Penny Lachance is a Care Manager with AOS Care Management. She can be reached at pennyl@aoscaremanagement.com.
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health
B R A I N H E A LT H
10 Ways to Start Improving Your Sleep Tonight! by Karen D. Sullivan, PhD, ABPP
As we age, our ability to get a deep, continuous night’s sleep decreases due to the brain’s reduced production of human growth hormone and melatonin and changes in our circadian rhythm (the body’s “internal clock”). These changes, combined with more frequent trips to the bathroom due to an enlarged prostate in men or decline in antidiuretic hormones in women, can be frustrating and lead to a fitful, unsatisfying night’s sleep. Research shows that among older adults, interrupted sleep, rather than total amount of sleep, most negatively affects the brain’s ability to think clearly and learn efficiently. Cognitive symptoms due to chronically poor sleep can include a decreased ability to concentrate, multi-task, learn new information, reason, process complex information and engage in critical thinking and decision-making. Interrupted sleep in older adults usually occurs in two different phases: sleep maintenance problems (awakening several times throughout the night) or sleep termination problems (waking up before you have slept enough to feel rested while being unable to get back to sleep). Beyond the age-related changes that affect sleep, poor quality sleep can be caused by other modifiable factors that can be improved, including a high level of stress (excessive worrying), lack of a routine sleep-wake schedule, medication side effects, lack of exercise, chronic pain or caffeine intake after 3 p.m. Experts say that there is no universal “magic number” for how many hours of sleep older adults should get. Sleep need is an individual matter that varies from person to person. Your magic number is the amount of sleep that leaves you feeling rested and “clear-headed” when you wake up in the morning. Research suggests regularly getting seven to eight hours of uninterrupted sleep is optimal, and following these ten rules of sleep hygiene may help you achieve this goal:
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1. Keep a regular sleep schedule by going to sleep and waking up around the same time every day. 2. Reduce caffeine intake, especially after lunch, and limit liquid intake two hours before sleep. 3. Avoid sugar after dinner. Spikes in our blood sugar due to sweets or simple carbohydrates can reduce the amount of time you spend in the deeper, restorative stages of sleep. 4. Try to get at least one to two hours of sunlight each day to help regulate circadian rhythms. 5. Use of the bed should primarily be restricted to sleeping and physical intimacy. Reading, watching TV and other activities in bed can make it harder for the brain to transition to sleep. 6. Develop a pre-sleep ritual. Listening to soothing music, practicing deep breathing, doing gentle yoga or watching a fire in the fireplace are ways to give your body and brain the message that it is time to wind down and stop “doing.” 7. If you do not fall asleep within 30 minutes of going to bed, get out of bed and do something that may increase sleepiness, such as reading a book, and then return to bed. However, do not use devices or watch TV. 8. Avoid over-the-counter medications for sleep with PM in the title (remember the PM part has anticholinergic properties known to have a negative effect on memory in older adults). 9. Keep a worry journal to write down and let go of nagging anxieties before bedtime. The key is to face stressors directly in our waking hours with assertive communication and action steps. 10. If none of these recommendations work, discuss your sleep concerns with your primary care physician to see if you should undergo a sleep study. Many sleep problems are caused by underlying but treatable issues. By identifying the root cause of your sleep problem, your care can be personalized.
Dr. Karen Sullivan, a board-certified clinical neuropsychologist, owner of Pinehurst Neuropsychology Brain & Memory Clinic and creator of the I CARE FOR YOUR BRAIN program, can be reached at 910-420-8041 or by visiting www.pinehurstneuropsychology.com or www.icfyb.com. | AUGUST 2018
Additional Sleep Tips by Rachel Stewart
Sleep needs change with age, as the American Academy of Sleep Medicine found that 13 percent of men and 36 percent of women over the age of 65 had issues falling asleep at night. For a restful night, consider these sleep hygiene highlights.
Make your space more sleep-friendly. Comfort is key when you’re getting ready to fall asleep. Keep your room cool and dark. This also means keeping it free of distractions like television, smartphones, tablets or other gadgets. Research suggests that just the light from your phone screen could interrupt your sleep patterns, so consider putting it out of reach and out of your line of sight if scrolling has you staying up. Consider changing the bedding as well so you’re as cool or as warm as you prefer to be. Adding a foam mattress pad can also provide extra comfort for achy joints, while heavy sound-cancelling curtains can keep the room extra quiet and dark. Seek out supplements. Looking for a little extra help to get settled for the night? You’re on the right track, as
we age, we experience hormone changes that make it harder to get to sleep. Natural supplements like melatonin - a hormone the body produces to make you sleep - are available over the counter. Just be sure to discuss any supplements with your primary care physician or pharmacist before you start taking it in case of interactions with other medications or vitamins you may be taking.
Tackle your triggers. Other times, daytime food and drink can be what’s wreaking havoc on your sleep
schedule. Craving a warm drink before bed? Stick to decaf coffee or an herbal tea like mint or chamomile, which may help you wind down. Also nix heavy or spicy meals before bed, as these can lead to acid reflux or upset stomach. Sipping wine or something stronger right before bed? It’s true that alcohol can provide relaxation, but over-imbibing can actually lead to disrupted sleep in the long run, so it’s best to skip the nightcap.
Speak with a specialist. If you’re experiencing consistent problems falling or staying asleep, it’s time for a medical consultation. Your primary care physician can refer you to a sleep specialist. This provider will discuss any issues you’ve been having as well as your medical history and recommend a sleep study. During a sleep study, you’ll stay overnight at a facility where technicians will monitor your sleep patterns. Once the sleep study is complete, the sleep specialist will recommend care based on your condition, whether it’s insomnia or something more complex, like sleep apnea. To learn more about sleep hygiene or sleep disorders, visit sleepeducation.com.
Serving residents of Scotland, Robeson, Richmond and Hoke counties in North Carolina, as well as Marlboro, Dillon and Chesterfield counties in South Carolina.
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AUGUST 2018 |
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life
COOKING SIMPLE
Fresh Watermelon and Feta Salad by Ray Linville
It’s hard to improve on the flavor and appearance of a luscious, chilled watermelon during the hot days of August. When you’ve tasted watermelon grown in the South, you’ve savored “what the angels eat,” Mark Twain told us in his novel Pudd’nhead Wilson. My grandkids would agree with Twain, who also considered the Southern watermelon to be “king by (the) grace of God over all the fruits of the earth.” Because it’s so complete by itself, they’re happy with just a slice of watermelon. However, at a party for adults, it may need to be a bit more embellished, particularly when the ladies are wearing high heels and fancy jewelry or even dressing down casually but attractively for beer and barbecue. If you have friends and neighbors over for a summer appetizer, don’t treat them as angels who would know that watermelon by itself is heavenly. On planet
Earth, do serve watermelon but first dress it up with goat cheese. Sue Stovall of Paradox Farm Creamery in West End has been making goat cheese since 2007. For August, she recommends teaming watermelon with a tangy goat milk feta, such as her Feta Complee (punningly distorting fait accompli in a play on words). Sold in brine, it adds saltiness to make the watermelon sizzle. “Feta in brine contrasts with the sweet watermelon and highlights the flavors,” Stovall says. “Sometimes I also add a little balsamic vinegar to give it more flavor.” Because it’s sweet, watermelon profits from the tanginess of goat cheese, which complements it with a tart, earthy punch. Adding a garnish of fresh mint makes it all taste like summer and helps everyone cool down with the refreshing watermelon flavor.
Ingredients - Makes 10 servings • Half of one small watermelon, preferably grown locally. • 4 oz. feta goat cheese • Bunch of small fresh mint leaves • (Optional) Aged Balsamic Vinegar
Directions
1. Cut half of one small watermelon into 1” cubes and place in large bowl. 2. Crumble goat cheese onto watermelon cubes. 3. Gently toss to combine. 4. Chill up to 2 hours. 5. (Optional:) Add a drizzle of aged balsamic vinegar. Gently toss to combine. 6. Garnish with mint leaves.
Ray Linville, a regular contributing writer of OutreachNC, has a love for Southern foods with a fresh twist.
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DID YOU KNOW? August is National Goat Cheese Month
• Goat cheese has less calories than cow’s milk cheese, approximately 75 calories per ounce— much less than mozzarella (85), brie (95), Swiss (108) and cheddar (115). • Goat cheese has less lactose and a protein structure that makes
it easier to digest. • Goat cheese also has more vitamins and minerals than cow’s cheese, including vitamin A, vitamin B, riboflavin, calcium, iron, phosphorus, magnesium and potassium. • Source: www.prevention.com
AUGUST 2018 |
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advice
T E C H S AV V Y
What is Wearable Technology? by GCFLearnFree.org | Art by Brenda Vienrich
Have you ever heard someone mention wearable technology but weren’t quite sure what that meant? Simply put, it’s a general term for a group of devices—including fitness trackers and smartwatches—that are designed to be worn throughout the day. They can connect with your existing devices, like computers and smartphones, which means they can do a lot of interesting things. FITNESS TRACKERS Whether you’re training for a marathon or are just trying to be more active, these devices can help you get a better understanding of your daily activity. They can track the number of steps you take, your average heart rate, how long you sleep and more. This data can then be synced with another device, which allows you to see trends and patterns in your activity. SMARTWATCHES If you’re not one to look at your phone throughout the day, you can sync it with a smartwatch to see notifications on your wrist at a glance. Most smartwatches rely on a smartphone to function, so if you have an iPhone you’d need an Apple Watch and if you have an Android you’d need a Moto 360 or Samsung Gear device. SAFETY WEARABLES Safety wearables are designed to help you in situations where you feel threatened or in danger. They’re sometimes disguised as jewelry so they can be used in a discreet way without letting a potential attacker know what the user is doing. Most are operated by a button that sends an alert to others, sounds a loud alarm or both.
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PROS AND CONS With no sign of the popularity of wearable technology slowing down, it’s important to consider their pros and cons. On the plus side, wearables give us the ability to monitor our fitness levels, track our location with GPS and view text messages more quickly. They’re also hands free and portable, eliminating the need to take our devices out of our pockets. At the same time, wearables tend to have a fairly short battery life. For some, it can be a hassle to remember to regularly remove a wearable to charge it. Some wearables have also been reported to measure data inaccurately on occasion. This can be especially dangerous when measuring something like a heart rate. Additionally, much of the data collected is unencrypted. Because most of these devices are used with wi-fi and Bluetooth connections to transmit data, cybercriminals can get their hands on it pretty easily. This information then becomes big data to be collected
and used by companies and governments. Like it or not, this tracked information could be used for marketing or health purposes.
MOORE COUNTY’S
THE FUTURE OF WEARABLES A number of industries are developing new and innovative types of wearable technology, especially in health care where they’re looking to take a step beyond fitness trackers to create health care trackers. These could be used to monitor things like blood pressure, vital signs or blood sugar levels for diabetics. Even devices like smart hearing aids and glasses that measure vision performance are becoming available to both medical professionals and the general public. Other devices like pet trackers, smart jewelry, AR/VR headsets and even shopping and security wearables are continuing to grow and gain momentum. There’s a lot of potential for wearable technology at the moment. It’ll be interesting to see where things go from here and how they continue to impact us both individually and as a society. To learn more, visit gcflearnfree.org/wearables/
AUGUST 2018 |
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life
THE READER’S NOOK
Fly Girls: How Five Daring Women Defied All Odds and Made Aviation History by Keith O’Brien Book Review by Michelle Goetzl
We take airplanes and air travel for granted today, but in the 1920s and ‘30s airplanes were still new and exciting. Most people have heard the names Charles Lindbergh and Amelia Earhart – not necessarily because of their skill as pilots, but rather because of the tragedies that befell them. In his new and exciting book, journalist Keith O’Brien tells the story of the world of aviation in those years and the dangers it held while focusing on five female pilots who worked to crack the glass ceiling. O’Brien spent countless hours researching Fly Girls: How Five Daring Women Defied All Odds and Made Aviation History, assembling these facts into a captivating story. Each of the women that O’Brien focuses on could be the subject of a book herself. One was Louise Thaden, a welleducated woman in the time when many were not, was a serious pilot, but also a mother and wife. Ruth Nichols was a girl who came from money and was supposed to marry well, but was seduced by the feeling of flight. She was willing to do pretty much anything to be the best. Amelia Earhart was out to prove that women could achieve anything and had the power of money behind her. The beautiful and stylish Ruth Elder used her charm to her advantage, while Florence Klingensmith – the best mechanic of the bunch – could give the boys a run for their money in speed races. O’Brien gives readers the backgrounds on each of these women and how they wound up with a love of flight. Every story needs an antagonist and in Fly Girls, Cliff Henderson assumes that role. Henderson was a 18
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successful promoter of the national air races – a race where the women wanted equal access and treatment. Fly Girls follows the races as well as other aviation records that the women pursued over the years. The history of aeronautics is as fascinating as the history of women’s rights. Planes were dangerous at times and not enclosed, so warm layers and goggles were necessary. Air races were as popular as NASCAR. And given that you can now fly from Los Angeles to New York in a touch over five hours, it is hard to imagine a time when that same flight took 19 hours if a pilot undertook it nonstop. Even transatlantic travel required a stop in Newfoundland. In terms of the rights of these pilots, they had to fight for equal treatment and people were always looking for some reason to blame the pilot instead of the airplane when they were involved. Men didn’t want them in their races; didn’t want them in their territory. The women had to tread lightly, but they organized and worked together to achieve parity. O’Brien has crafted a readable and exciting book about the adventure, tragedy and determination faced by pilots, male and female, during the ‘20s and ‘30s. If you liked Boys in the Boat or Unbroken, you will love Fly Girls. Michelle Goetzl writes an online blog—“Books My Kids Read.” She loves books and sharing that love of reading with children. She can be reached at booksmykidsread@gmail.com .
advice
H O M E S TA G I N G
How to Prepare Kids (or Grandkids) for the Move by Kasia McDaniel
There was dead silence and big wide eyes as I looked at my kids. We had just told them we were selling our home and moving out of state and then the tears started – on both sides. “Why do we have to move?” “We are moving for both Mommy’s and Daddy’s jobs,” we said.
It was heartbreaking to tell them. We knew how much they loved their friends and this would be a first move for them. We explained that we, the parents, would also have to make new friends and find new places to play and new restaurants. The tears rolled even more until we started to talk about the new town. We said we need help finding a new house and new playgrounds, new schools. That got their attention because they love to look at new houses. They then started daydreaming about what the new house would look like and what it had to have. GET THE KIDS INVOLVED Of course, the next step was to get the house ready to sell. With three kids, I knew this would be a challenge. The single best piece of advice I could give when it comes to moving with kids is to get them involved. It can be as easy as having them look up the new town online and create a list of playgrounds, schools and places to visit. Turn it into a trip where you act like a tourist and find all the things that would draw people to the area. As for the house selling portion, explain there will be some changes in the house when it goes on the market. Explain there will be people coming in and you have to keep it clean. Let them choose a few favorite toys and books they can’t live without and store/pack the rest away to help declutter the
home. My favorite part of the move was when the moving truck pulled up with our treasures at the new home and the kids got to unpack their toy boxes. It was like Christmas all over again! They were content playing with their long-lost toys while we unpacked the rest of the boxes. GRANDPARENTS If you are moving closer to grandparents, they can help watch the kids or entertain them by taking them exploring in the new town. Sometimes the parents need a few hours to get a room set up without kids interrupting every few minutes because they are bored and the TV isn’t hooked up yet. The kids can also be a great tour guide when their grandparents come over. Let them show grandma and grandpa where their new school will be, the hospital, the church or their favorite new restaurant. That way, when they talk to their grandparents who live further away, the grandparents can envision the town and their experiences. It is also a great way for them to make new memories like visiting the ice cream shop or bakery. Kids are resilient and will roll with the punches as long as they see that you are reacting to the move in a positive way. New places give them a chance to make new memories. You can make it easier on them (and you) by including them in some of the decisions and perhaps involving the grandparents to help make the transition smoother into a new home. Kasia McDaniel, a Home Stager and Certified Interior Decorator at Blue Diamond Staging can be reached at 910-745-0608 or by visiting www.bluediamondstaging.com
KAREN D. SULLIVAN, PHD, ABPP Board-Certified Clinical Neuropsychologist
TAEH A. WARD, PHD Clinical Neuropsychologist
MARYANNE EDMUNDSON, PHD Clinical Neuropsychologist
Personalized Treatment Recommendations that Emphasize Brain Health, Independence and Quality of Life Schedule an appointment
910-420-8041
HEATHER TIPPENS, LPC Licensed Professional Counselor
45 Aviemore Drive | Pinehurst AUGUST 2018 | OutreachNC.com 19 PinehurstNeuropsychology.com
life
PURSUIT OF MEMORY
Just the Other Day: In Real Time Together by LuEllen Huntley
In late December 2013, my father begins to show signs of end-of-life Parkinson’s disease syndrome. Our family decides to pursue skilled nursing as the option before the complex becomes more acute. I recall one of the professionals saying, “A transition from home to skilled nursing goes one of two ways; a resident either adjusts or declines.” In my father’s case, it becomes the latter. My mother – quite present during the final weeks of my father’s life – remains devoted as ever. From January 29, 2014, the date my father passes away, until August 2017, Mother enjoys independent living in a welcoming continuing care community. Then this changes. She falls, breaks her left hip, and a descent into dementia presents.
their time and attention; the atmosphere here never fails. Sharing healthy fare in a relaxing place marks our time together.
On this day my mother notices rings I am wearing. At times I place on my left hand my father’s gold wedding band and mother’s emerald and diamond ring on top of the wedding band. My mother notices rings. She does not, however, recognize her emerald and diamond ring or Daddy’s wedding band. A loved one whose mind erases itself offers a peculiar knot that cannot well be untangled. She thinks I bought new gems; our conversation shifts to jewelry for a few minutes before talk changes to the topic of selecting homemade delicacies from the dessert case. Mother loves to look and choose several to take home for later. Thyme and Place owner Leslie Philip and servers LaDonna Koontz and Missy Chapman grace us with
we secure even better parking and go in the small store without upset or questions about what we are doing. Fortunately, Opulence carries Patricia Green bedroom shoes in mother’s size – soft pale blue. Perfect fit. I make the purchase, unrushed to savor the experience of buying a gift for my mother in real time together.
After lunch I think it a good idea to chance another venture as mother can use a new pair of house slippers with substantial back and sole. I think – Opulence of Southern Pines, downtown on NW Broad Street, as I know this specialty boutique carries pajamas, robes, and all things bedding and bath. Belk seems much too far at this point in the afternoon; Bed, Bath, and Beyond, too big and frantic. Parking on NW Broad Street – a cinch this day – seems a good omen, but for some reason my mother becomes upset because “It is a weird kind of grieving she thinks my intention is As of late, I never know what to shop for myself. Nothing process, losing somebody over a I say makes sense at this to expect when my mother and I venture out these days moment once she fixates on period of time.” because Alzheimer’s dementia this thought. I realize it best to In Pursuit of Memory: continues to manifest in abort looking for house shoes The Fight against Alzheimer’s emotional upsets, delusions, and take mother back to the – Joseph Jebelli fear and a spectrum of assisted living facility where unpredictability. Recently my she lives. mother and I share the European Brunch at Thyme and Once there, I prepare for mother a bit of Thyme and Place Place Café in Southern Pines. Deviled eggs, assorted meat chocolate icing cheesecake and serve with a Coca-Cola and cheese, tomatoes, red peppers, fruit and a biscuit with over ice. The treat agrees, but as soon as mother’s attention butter and jam remind me of an English ploughman’s transitions from the afternoon dessert, she says, “I want lunch. The café, cozy and uncrowded, meets criteria for to go shopping; I need new house slippers.” I think, all a satisfying outing. Mother settles in with a glass of fresh right. Off we go on the house slipper mission for a second lemonade. time. I trust intuition and go back to Opulence. This time
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The best part of the afternoon happens when we return to her “forever” home at the continuing care community. “I love my new slippers,” she says. And she does not give them back to me which sometimes these days she wants to do. These slippers she accepts as hers. Several days later when I am visiting mother she says, “I
better put on my slippers.” Good idea. I ask, “Where did you get these?” She says, “I got them just the other day.” What details she may remember I have little clue. Every other day or so my mother asks about her rings and other jewelry. I say I am keeping all her valuables safe with me. This answer appeases. My parents were high school sweethearts and married during their senior year at UNC Chapel Hill in 1951. They have a son, and I am one of their three daughters. My mother often asks me, “What does Daddy look like now?” I say, “He is as handsome as ever,” and leave it at that.
LuEllen Huntley, a native North Carolinian from Anson County, currently lives in Southern Pines and teaches at Sandhills Community College. An Associate English Professor Emerita, Dr. Huntley taught at UNC-Wilmington in the English Department for 26 years.
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health
THE TRIUMPHANT ELDER
Indigestion Rx in the Spice Rack! by Tim Keim, EYT500, Yoga Therapist
Indigestion can come in several forms: gas, bloating, belching, flatulence, hyperacidity, sluggish elimination or constipation. We all experience some of these in our lives and symptoms can increase with age and certain medications. For thousands of years our ancestors used common culinary spices to achieve what we might now term uncommon relief for the above symptoms. Not only are these herbs strong and effective, they are safe, gentle, nourishing to the effected tissues and a lot less expensive than prescription or over-thecounter meds that can cause serious side effects. The ancient medical science of Ayurveda is well over 5,000 years old, and is in many ways the mother of modern medical traditions with which it has much in common. Many of today’s medicines are derivatives of their herbal antecedents. Gastritis (hyperacidity) is often caused by the ingestion of some kind of irritant like aspirin, ibuprofen, alcohol or excessively hot foods. When these irritants combine with stress and the H. pylori bacterium, ulcers can result. Removing the offending irritant is a good start. Common herbs like fennel, cardamom, cumin, licorice and dandelion root can quell hyperacidity. These may be prepared by steeping 1/81/4 teaspoon of each of the above herbs in a cup of boiling water for five to ten minutes. Add a wee bit of honey and sip at near body temperature. Herbs can also be mixed into a small portion of food and taken during a meal. Start with a low dose and see how you respond. If the herbs have been in the cupboard for over six months, it’s time for fresh stock. Flatulence can be caused by eating too much or too fast, improperly combining foods, alcohol or eating while upset. Fruit with other types of food can be a contributor, so it’s
best to eat fruit by itself as a snack. The carminative or gas dispelling herbs that are also cooling for the digestive tract include fennel, coriander, peppermint, chamomile and lime. Warmer herbs like basil, cinnamon, cloves and nutmeg are equally effective if hyperacidity is not a factor. Constipation is epidemic in the western world, largely owing to our inadequate fiber intake. Laxative herbs can provide bulk fiber, moisten digestive contents or stimulate peristalsis (muscular contraction of the gut). Psyllium, without the sugar of drugstore preparations, can be mixed with diluted juice and chased with adequate water. Flaxseeds ground into a meal in the blender can be used the same way or mixed into warm oatmeal, stews or soups. Stewed prunes are also great and a nice sweet treat in your oats for breakfast. For stubborn constipation, try cascara sagrada or senna, easily obtained at your local natural foods store. Many serious diseases can be averted by taking care with digestion and daily elimination. Simple guidelines include eating slowly; chewing thoroughly with the mouth closed, eating quietly without the distraction of media, eliminating cold drinks to protect digestive strength and pausing to a state of calm and giving thanks. Tim Keim is an IAYT certified yoga therapist, and has been teaching yoga for 15 years. Keim can be heard Saturday and Sunday mornings from 7 a.m. to 1 p.m. on 91.5-FM, WUNC. He can be reached at timkeim811@yahoo.com.
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ROLE REVERSAL
advice
Equilibrium: Navigating Your Work-Life Balance When You Live with An Aging Parent by David Hibbard
Perhaps it’s just my own view of the world today, or maybe it is indeed a reality, but it seems our lives are busier than they have ever been. The reasons for that could be the topic of an entirely separate article. But whatever the reasons, many folks today seem to be in a constant mad scramble to cram as much as they can into their waking hours. If you live with a parent, or if you don’t live with them but have some level of responsibility for their well-being, the demands on your time can seem even more taxing. The reality of time as a finite commodity is emphasized even further if you are working, either part-time or full-time. In my case, I have a round-trip commute of approximately two hours each day to my job, so finding quality time to spend with my mother when I get home, and to lend a hand to anything that needs to be done around the house, can be challenging. Juggling the expectations you have for your own career as well as your desire to be there for your parent is just that – a juggling act. Here are a few tips from my own experience that can hopefully help you find the right balance for your own situation: ASSESS YOUR PARENT’S NEEDS: How much help does your parent need from you on a daily basis? Are they still independent and active, or do you assist with some of their daily tasks? In my own case, I live with my mother but am fortunate that she is still entirely independent and doesn’t require help with things like getting dressed or going to the store. Still though, because I live with her, I want to help with certain tasks. And that’s my point here – discern the difference between what you need to help your parent with and what you want to help with. This will help you allocate your time most effectively. TALK WITH YOUR PARENT ABOUT IT: Make sure your assessment of your mom’s or dad’s reliance on you is in line with how they see it. Ask questions, and let them ask questions of you – you might not even realize they would appreciate your help with balancing their checkbook until you ask. THEN TALK ABOUT IT: Have a conversation with your parent about the demands of your job outside the house. Talk
about the time constraints you may have at home because of your career. This is also an opportunity to plan and avoid, as much as possible, conflicts between your work and home responsibilities. We find it helpful to sit down with a calendar periodically to look at the next few months. I am able to outline for mom the dates and times I will have to work in the evenings or on weekends so there are fewer surprises for her. If there are medical appointments or other events my mother would like me to attend with her, I can try to arrange my schedule accordingly. This brings up another point... TALK WITH YOUR EMPLOYER ABOUT IT: Be upfront with your place of work about your role as a caregiver or an additional support to your parent. Again, planning is the key here because the demands of every workplace are different. Keep the lines of communication open and talk well in advance with your employer about any absences you anticipate because of your parental obligations. Demonstrate to your employer that you can be trusted with time away, too; as soon as you return, always follow through on any work tasks that had to wait while you were gone. CONTINUE TO ASSESS YOUR FAMILY’S SITUATION: If life teaches us anything, it’s that nothing stays the same. Your parent’s needs will continue to change, and it’s very likely your responsibilities at work will continue to fluctuate, so revisit the balance you are maintaining between the two on a regular basis. Every family is different, and what we need will be different at various times. Maybe the day will come when you want to cut back from full-time to part-time work to be more available to your parent; if so, begin planning for that now. Whether you work with a financial planner or manage your own investments, look far down the road at your own goals and how you can best position your family to get there.
Share your role reversal stories with contributing writer David Hibbard. Email him at: hib1967@gmail.com
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Dream Sleep Science & Mystery
by Jennifer Webster | Photography by Mollie Tobias
What do scientists know about dreams? And what’s still a matter of fantasy and folklore? Our experts help us find out. 24
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First, the science. People generally cycle through four stages of sleep several times during the night, with the last phase, known as rapid eye movement or REM sleep, getting longer each time around. Dreams generally occur during REM sleep; we can even imagine people’s eyes are moving to “watch” their dreams. Yet despite all the time we spend sleeping and dreaming, scientists know relatively little about sleep and dreams, says Karen D. Sullivan, PhD, ABPP, board-certified neuropsychologist and owner of Pinehurst Neuropsychology Brain & Memory Clinic. “Each [stage of sleep] performs unique restorative functions across all systems of the body, with a particular focus on cellular, immune, cognitive and psychological health,” she explains. “REM sleep specifically is thought to be essential for two functions: first, the formation of new memories, especially procedural memory… and second, a type of deep cleaning, where the immune system and brain ‘cooperate’ to remove waste products that build up during the day.” One misconception about dreams is that they all occur during REM sleep; Sullivan explains that they most frequently occur then, but not always. And scientists have not yet discovered the algorithm that determines how the brain turns housekeeping and memory formation into engaging stories (or horrific nightmares). “The exact purpose of dreaming is not known,” Dr. Sullivan says. “It is likely a method of emotional processing, particularly of life experiences that are distressing to us in some way. Our hippocampus, the learning and memory centers of the brain, and frontal lobes, essentially ‘replay’ the day’s events all night long. The purpose is to compare notes from our day against the backdrop of total life experience with a specific eye on discrepancies. If something surprising or unexpected happens, it gets reviewed, or processed, until the lesson is learned.” The process, Dr. Sullivan says, is the brain’s way of reconciling an unexpected or traumatic event with the larger backdrop of our memories. It’s an attempt at making meaning. “Through this ‘replaying’ process, we decide what can be forgotten and what should be moved into long-term storage in the cerebral cortex,” she says. Yes, some dreams do seem like replays and sorting tools. For instance, when I dream about real people and events, I can guess that maybe I’m sorting out memories. But some other dreams seem pretty fantastic. I’m certainly not the only one who’s been pursued by dragons or witches in dreams, or received gifts from beautiful fairies. Are those memories, too? Where do dream stories and people actually come from? I ask Sullivan for the academic perspective on dream meanings. “Dream interpretation comes down to two things for me: symbols of the personal and collective unconscious,” she answers. “The themes and images of dreams are not random; they are symbolic and related to both our unique, personal life history and to the history of humans across generations and cultures.” She refers me to Carl Jung, one of the creators of a school of psychology known as depth psychology, which holds that people have an unconscious, spiritual aspect that informs our lives. Jung also taught that people’s unconscious life is AUGUST 2018 |
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partly shared or collective, a grammar of universal symbols out of which we create meaning. “Carl Jung taught us that there are many dream symbols that are universal and occur in people living in all types of life circumstances, such as being lost, unprepared for a responsibility or threatened by forces of the natural world,” she says. This fascinates me. If the symbolic language of dreams is universal, do our dreams know more than we do? And can they affect us—or we, them? DREAM MASTERY It’s hard, but not impossible, to manipulate one’s dreams. Some medications, for instance, produce good or bad dreams. Dementia patients who take donepezil may experience nightmares, Sullivan says. And personally, I find one happy side effect of allergy season is the delicious flying dreams I get while taking Montelukast sodium. On the other hand, people who suffer from nightmares, such as veterans with post-traumatic stress disorder, may experience relief from prazosin, which is also a blood-pressure medication, Sullivan says. Then, there are people who believe they can direct their dreams, re-writing unpleasant scripts or just planning a happy adventure. I remember my granny putting me to sleep by telling me a story about a unicorn or mermaid. “Now fall asleep to see what happens next,” she would say, tucking me in. I don’t remember whether it worked, though! But other groups claim to teach directed or “lucid” dreaming. DREAM AWAKE Like the ballet by the same name, dreams are when some of us feel the most awake: colors are brighter. People and places seem more real. Others of us never remember dreams, or only recall traces. Whether they feel true or, well, dreamy, dreams are typically composed of things that are more the purvey of art, myth and religion than of science: stories. Here are a few ways humans have understood dream-as-story. • Divine messages; for example, the God of the Christian Bible directs Joseph to take his family and flee from Herod. • Predictions; for example, Harriet Tubman said that she previously dreamed much of what later happened to her as she began to rescue slaves from the South. • Creation; for example, in the Abenaki creation story, the Creator dreams of all the animals, and when he awakes he finds that they have come into existence. How do you interpret your dreams? Through the lens of biology, psychology or myth? Whatever your approach, there’s probably more to your dreams than meets the eye. 26
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TOOTHY SLEEP TROUBLES When your emotions seep through into your sleep, you may find a help in an unexpected place: your dentist’s office. “There are two main issues connecting teeth and sleep,” says Laura Wellener, DDS. “One is sleep apnea and the other is bruxism, or teeth grinding.” Sleep apnea, of course, is the condition in which people periodically stop breathing during sleep. Often caused by excess weight, sleep apnea may also cause snoring, snorting and — since the body realizes there’s something wrong when it doesn’t get enough oxygen — stress. That stress is what may alert the dentist. “When people with sleep apnea are sleeping, the excess tissue in the back of their throat collapses, and they may wake gasping for air,” Wellener explains. “We’re now finding that those people clench and grind their teeth, possibly because the brain signals the jaw muscle to clench up as the airway collapses. The other side of that is that when there is not enough oxygen in the blood stream, the body has a stress response.” And stress, Wellener says, is one common cause of tooth-grinding. The cycle becomes vicious when bruxism interrupts the sleep cycle, leading to interruption of slow-wave “delta” sleep and consequently to stress and depression. “If you grind or clench your teeth [you won’t wake] up refreshed,” Wellener says. “When you grind your teeth you won’t go into the delta phase, or deep phase, of sleep. In the delta phase, the muscles relax, and they won’t get there if the jaw is tensing up.” As well as stress, missing teeth or poor dental alignment can lead to tooth-grinding, Dr. Wellener says. A dental visit can lead to a diagnosis of bruxism based on signs of eroded enamel or unexplained cracks or chips. If you have jaw and muscle soreness around the face, or unexplained tooth pain, be sure to mention those signs to a dentist. “If you’re just grinding your teeth, a nightguard is the treatment,” says Wellener, who swears by hers. “They decrease the force when you grind, helping you relax your jaw muscles. That should improve sleep quality.” And if you have problems with grinding your teeth, your dentist may be your first line of defense against sleep apnea. With a few key questions, he or she can point you to a sleep study and a long-term plan for better sleep.
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Birding in N.C.
Dunn-Erwin Trail
by Ray Linville | Photography by Brady Beck
Enjoying Nature Along a Former Rail Line 28
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YOUNG EASTERN SCREECH-OWL29 AUGUST 2018 | OutreachNC.com
Do you enjoy strolling through farmlands, beside cotton fields and across wetlands? Then plan an excursion on the Dunn-Erwin Trail, which occupies the former rail line in Harnett County that connected the Erwin Mill to the Cotton Exchange Yard in Dunn. The 5.3-mile gravel trail is a part of the N.C. Birding Trail, which links educational and historical attractions with communities and businesses across the state. The Dunn-Erwin Trail is popular with casual walkers, runners and bikers because its surface is flat and well-maintained as well as with families because dogs on leashes are welcome. Trail heads are located in the downtown areas of Dunn and Erwin and are convenient to shops and restaurants. The trail has multiple access points in both communities where it intersects streets at several locations, and it is wheelchair accessible before it enters into farmland.
KENTUCKY WARBLER The trail is home to a variety of migrating and breeding warblers, such as the Kentucky warbler that is more often heard than seen and is identified by a loud “churee” song. Found throughout the forests of the Southeast, this warbler stays near the lower levels of woodlands and nests on the ground at the base of a shrub or in an area of abundant vegetation. Unlike most songbirds, the male sings only one song type and never changes it throughout his life.
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The Kentucky warbler has yellow underparts that contrast with its olive-green back. The black marks down the side of its face and on its throat give the appearance of being “sideburns.” Another curious feature is a yellow eye-stripe that wraps about the back of each eye to form “spectacles.”
EASTERN SCREECH-OWL Because the trail is the home to many songbirds, it’s also the residence of the Eastern screech-owl, a predator known to eat a variety of songbirds. In fact, smaller birds can help you to find the screech-owl during the day when they swoop around it with noisy calls and mob it to create such a nuisance that it moves away. The noisy calls alert other songbirds to the screech-owl’s presence and teach younger flock members about the danger. Although screech-owls are mainly active at night, they do hunt occasionally in daylight and often at dawn and dusk. Both males and females sing, and mated pairs sing to each other in alternating turns during the day as well as at night. The calls of screech-owls are screeches (the reason for their name) when defending nests as well as low, soft hoots. Screech-owls are perfectly camouflaged and can be mostly gray or reddish-gray. Regardless of the color, their patterns of complex bands and spots provide exceptional camouflage against tree bark. They live along the trail in trees where they nest in holes and cavities opened or enlarged by woodpeckers, squirrels or other animals. They never dig a cavity themselves and often occupy abandoned woodpecker nest holes.
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DOWNY WOODPECKER The reliance on woodpeckers for nesting support means that the trail is also home to a variety of woodpeckers, including the downy woodpecker. This bird nests in dead trees or decayed parts of live trees. Both the male and female work to prepare the nest hole, an effort that can take up to three weeks. They are black and white, although only the male has a red nape. Woodpeckers don’t sing, but they drum loudly against pieces of wood (or metal). This month especially the downy woodpecker makes a lot of noise, both with a shrill whinnying call and by drumming on trees. The male and female divide up where they look for food. They mainly eat insects, including insects living on or in the stems of weeds that larger woodpeckers cannot reach. About a fourth of their diet consists of plant material, such as grains and berries. Along the trail they share the wooded space with other species, such as red-bellied, pileated and red-headed woodpeckers among others.
DUNN-ERWIN TRAIL The scenery along the trail is varied. The path crosses the Black River headwaters and floodplain. The adjacent forest includes oak and pine, and parts of the trail pass through small wetland communities. Wading birds, migrating shorebirds and other waterfowl often frequent the ponds along the trail. Part of the East Coast Greenway, the Dunn-Erwin Trail has interpretative markers and signs about area history. Updates on the trail’s status, such as when organized runs and repair activities are scheduled, are posted routinely on the trail’s Facebook page (@thedunnerwinrailtrail). OutreachNC has embarked on a yearlong series that highlights regional sites of the N.C. Birding Trail. Enjoy the series as contributor Ray Linville explores beautiful landscapes and birds of our home state. He can be reached at linville910@gmail.com.
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The Importance of the Right Fitness Equipment: Carolina Conversations with Greg Combs of May Street Bicycles, Dana Myers of River Jack Outdoor Trading Co. and Bridget Cook of RIOT (Run in Our Tribe). by Corbie Hill | Photography by Mollie Tobias
This month we felt like doing something a little different. Instead of speaking with one person for our Carolina Conversations feature, we spoke to several professionals about the importance of proper fitness equipment. Our theme this month, after all, is “Living Healthy,” and a major part of that is keeping active. Greg Combs, owner of May Street Bicycles 1110 N. May Street, Southern Pines 910-528-4365 maystreetbicycles.com OutreachNC: How does someone who wants to start biking ease into it so they don’t hurt themselves?
Greg Combs: Number one, they have to be healthy. They 34 canOutreachNC.com stand up, sit down|–AUGUST the basic2018 human functions, up and down stairs. If they’re comfortable riding on a stationary
bike at the fitness center and they can do that 15, 20 minutes at any pace, then I would say consider getting the dust off your bike and riding. The next piece to that is safety – wearing a helmet, putting a light on the bike so people can see you from behind. People driving, they can’t read your mind, so you have to be on the road in a manner that is predictable. If your goal is “I want to do ten miles today,” you may be better off doing 20 half-mile laps because maybe after lap five or six you may feel like you need to [take a break]. So going out and turning back – set goals. How far can I go? With my head injury, there’s days I feel fantastic, but there’s other days I don’t. So I do a 28 mile loop, and there’s five or six cutoffs where I can shorten it. A half-a-mile loop is not uncommon around here. You can do that. If you live
in a golf community, there’s all kinds of places you can ride in a golf community, and even here in Southern Pines. And then your basic stuff – be hydrated, in this heat and the humidity. In terms of selecting the size of your bike, is that an issue of safety or comfort or both?
It’s a combination. I think having something that’s more upright – you don’t have to be perpendicular to the ground, but somewhere between 15 and 20 degrees bend over to almost straight up is best for seniors. Getting something like a flat bar bike, like a trail bike or a hybrid would be the best ones to go with. Hybrids have a whole lot of benefits but the downside is [they have] smaller tires, and if they’re not completely aired efficiently and you hit a rock, you can get a flat. When you turn a corner with a skinnier tire, where there’s a little bit of sand, that can be a safety issue too. I’m a big fan of the trail bikes. They’re totally multipurpose. You can ride around in the neighborhoods, you can ride around on the roads or you can ride on the grass or you can ride around the Reservoir. That’s not a bad place to ride if you’re wanting to get into it and you’re intimidated by traffic and people watching you in the neighborhood.
Greg Combs may own May Street Bicycles, but he opens up on a completely different tack. “Get a dog. Walk the dog. If that’s boring, get a bike,” Combs says. He stands in his store in Southern Pines, his Belgian Malinois Kilo leashed beside him. His rationale: you can talk yourself out of a bike ride if it’s rainy, if it’s too hot out – you get the idea – but a dog needs to be walked regardless of the weather. Kilo serves an additional purpose for Combs. In summer 2017, Combs was struck by a car while cycling and wound up with a cracked skull. He survived, but the recovery process sapped his energy levels. And then a friend suggested he get a “brain dog.” Now that he has Kilo, he has to get up and go – even if his energy level is low. “She gets me up at 5:15, 5:30,” Combs says. “There’s days we’ll walk an hour, an hour and a half.”
I’ve sold some of what’s called e-bikes – pedal assist or electric bikes. One guy was obese and every time he would come to a hill it would nearly kill him, so he got an electric bike. He pushes the button to help him get over [the hill, and] he’s still able to keep riding. He lost, like, 40 pounds. Another guy got a hip replacement, and we’ve got a lot of those folks around here. Same thing – every time he had to do some kind of high exertion it would aggravate the hip, so he got an electric bike. So he’s doing his rehab and day-to-day function. If it starts giving him an ache and a pain, he just pushes a button. E-bikes are fantastic, but they’re pricey. There are some you can get for around $2,300, and they go up to around $5,000, $6,000, $7,000. If you just want an around the neighborhood trail bike, those are $600. AUGUST 2018 |
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Bridget Cook, RIOT (Run in our Tribe) 205 NE Broad Street, Southern Pines 910-684-8707 riotsouthernpines.com OutreachNC: How important is it to run in the right shoe? What can happen to you if you’re in the wrong shoe?
Bridget Cook: The biggest thing that we see that people come in here with is shin splints. What we look for when someone comes in is what their foot does. You either pronate or supinate – I pronate pretty bad so I turn in, my feet flatten out. If I don’t have a shoe with support holding me up a little, it’s going to put a lot of pressure on your shins and your knees. You’re not going to want to run because you’re going to be in pain. We look for a few [things, such as] how your arch is, if you need a stability shoe or if you need a neutral shoe. You definitely need to be in the right shoe. If you just go to Dick’s and you pick out a shoe and it’s the wrong shoe, you’re going to get hurt. So really, just looking for what shoe they need first, whether it’s stability, neutral or motion control. Are there any age-specific questions older customers have?
Honestly, when an older person comes in and they say they’re either running or walking, I automatically go to Hoka. There’s a ton of cushion in them, and cushion is really important when you’re older because it softens the impact. Most of the older people are walking on the streets or the sidewalks, so you want something with a ton of cushion. You don’t want the minimalist shoes for them. The older people love Hokas. This is all cushion, so it’s going to soften the impact of the hard pavement and protect your shins, protect your knees and just make it really comfortable. A shoe is so personal – once you get your shoe, you’re going to live with it. Is there a way to test them out?
Most shoe companies give a certain period where they’ll take back the shoes if they hurt you, so we do two weeks where you can try them out. If they don’t work for you, you can take them back. Even trying on a shoe here, you’re not going to know how it feels until you take it out for a longer period of time. Even if you do like it, maybe there’s something you notice more when you’re walking or running that you didn’t notice in the store. I think they know that and that’s why the companies let you try stuff out first.
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Dana Myers, manager and buyer at River Jack Outdoor Trading Co. 181 NE Broad Street, Southern Pines 910-692-5225 riverjack.com OutreachNC: With trekking poles and walking sticks, what function do those have?
Dana Myers: We went on an outing with one of our groups and we got to test some of their poles. The difference is kind of amazing. It’s not that you need it so much, but it is kind of this helpful tool that you do notice an improvement in certain things. It’s not always the up, it’s really the down – down is a lot easier, but you go a lot faster. If you’re on a rocky trail or a lot of roots or something like that, it helps you maintain a pace and help with stability. I think most people who start using them could never go back to not using them. It’s one of those things – once you get the hang of it and the motion of it, then it becomes a really big, helpful tool. The walking sticks are kind of the same thing. Most people, when you’re on a trail in general, you kind of do it on your own – you find a cool stick and you pick one up. With the kids, they always kind of tend to do that. It’s kind of the same thing. It’s a helpful tool – you get cobwebs out if they’re in front of you. Around here I think a lot of people can use them on the street. There’s different bottoms that are used for different things. There’s a snow pick. If you’re doing it for aerobic activity, one that’s a little more rounded. Trekking poles help you maintain a pace and help with stability. As you were saying before the interview, people around here like them because it doesn’t look like a cane.
Exactly. It’s kind of a cool use for something that’s functional. Let’s switch to paddling. Do you have older customers who want to get into or back into paddling?
A lot of people around here either used to do it, maybe had to stop and are wanting to get back into it or they have older equipment that just needs updating. A lot of our customers just really want something to do aerobic outside. It’s an exercise tool. Their doctors told them they need ... help with their upper body and maybe they’re not gym people. Maybe they told them a kayak would be good for their upper body strength and things like that. It’s an AUGUST 2018 |
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awesome thing to get you outside and to get a little aerobic activity. There’s definitely a lot of opportunity around here to do it, and it’s easy stuff. It doesn’t have to be these roaring rapids. At Reservoir Park, just throw the boat in and go. How about the weight of the boats? Is a kayak tough to carry?
It depends. Our main boats that we sell are between nine and a half and ten and 11 feet, so we really kind of focus on the recreational lengths. Most boats range between 35 and 45 pounds in that length range. For some people, 35 pounds is not a big deal. I think the hardest part is getting it on a vehicle, and that’s the challenge for anyone – that’s the challenge for me. So people that maybe live on a lake and can drag their boat up on the grass beside it, then that’s a lot easier. But there are things to help that, like kayak carts that have the wheels so you can just drag it basically and have it off of the ground. Car top systems make it a little bit easier, too. Can you speak to the advantage of breathable shirts and breathable material?
We really try to look at things that have UPF ratings that are wicking, that get away moisture from your body, because it is so hot here. In the summer we talk about UPF and wicking and keeping you cool when it’s hot. In the winter
Howell Drug
Serving Raeford & Hoke County
311 Teal Drive
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Generally, most people want to be outside, they don’t want to be miserable and hot. They have to have sun protection because it’s important or their doctors have told them. So you can have a long sleeve shirt that gives you protection that doesn’t make you want to keel over. Some of our stuff has cooling fibers, so certain things actually are sweat activated, so when you sweat it actually has a cooling sensation on your skin. Even when you’re walking, the importance of good socks and good shoes and stuff that’s gonna promote health instead of making it harder to do those things. Blisters suck. Most people don’t realize that it’s not always your shoe that’s giving you the blister. It could be your sock that’s scrunched down in your toe that’s creating those hot spots. You might pay a little bit more for those things ... but it’s expensive for a reason. There’s technology behind this stuff. It’s not just a cotton sock that you can buy in bulk, but one pair of socks that’s $20 could last you 20 years.
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Age the way you choose. Let our resources & experience help you maintain your independence
We offer:
• Coordination of legal, financial and health care professionals • Caregiver referrals • Placement and transition assistance • Crisis Intervention • Ongoing dementia care services • Assistance with meals, bill pay and transportation
Call for your FREE consultation today! 910-692-0683 The Experts in Aging Well
OutreachNC.com www.AgingOutreachServices.com AUGUST 2018 |
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SANDHILLS REPERTORY THEATRE Broadway Concert Series presents
Out of the Friend Zone
MARISSA MCGOWAN
Music Direction
Bradley Kirk Gardner
Upcoming Revival Kiss Me Kate Little Night Music with Tony/Oscar winner, Catherine Zeta-Jones, Chess, Roman Holiday, Camelot, Showboat, Sweeny Todd
MICHAEL MENDEZ
Chaplin, FROZEN: A Musical Spectacular for the Disney Won der, Encores! Hey, Look Me Over! FAT CAMP the musical, HowDamn Yankees, Man of La Mancha , Billy Elliot, , Paquito’s Christmas
Two Broadway friends - looking for love in all the wrong places – then found it – with each other !
August 18 Saturday
7:30 pm
August 19 Sunday
P R E S E N T E D AT
2:00 pm
THE HANNAH CENTER THEATRE All Tickets at: www.touchinghumanityinc.org General (18-64) $32 Over 65/Military (with ID) $30 Student (18 & under with ID) $20 ONLY Senior/Military tickets can be purchased at Given Library (Pinehurst Village) & Country Bookshop (Southern Pines)
AT DOOR ALL TICKETS $35 40
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Proceeds help fund arts programming in the schools and special needs arts programming in the community
◆ Close to Downtown Shops, Dining & Golf ◆ Sleeps 4 Comfortably ◆ Pets Welcome with Deposit
info@aosvc.com | 910.692.0683 | AOSVC.com
910-947-2295
Jason C. Burgin, LUTCF, Agency Manager jason.burgin@ncfbins.com
910-315-4074
Linda D. Mabe, Agent jason.burgin@ncfbins.com linda.mabe@ncfbins.com www.ncfbins.com/moore-burgin/moorecountyoffice.html
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Life After Fear When leukemia struck, I bounced back. What followed has been the best year of my life. by Corbie Hill | Photo by Diana Matthews
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I have spent the better part of a year reconstructing a week’s worth of memories. It’s been a slow process, and there are still huge gaps – days’ worth of gaps – but I’m getting there. The memories in question are of the family trip to Oak Island in early August 2017, just before the start of our kids’ school year. With my wife Rachel’s help, I now recall that we saw my brother and some folks from her side of the family at the start of the week. I remember now that it rained for several of our days there. I remember that we packed umbrellas and took Sarah and Lucy, our kids, on a salt marsh boardwalk anyway. I remember, too, that we paid a dollar a head and walked to the end of the ocean pier. This is where Rachel took a really good picture of the girls. A few days later we were in my hospital room, and her phone slipped out of her hand. It didn’t fall far, but it was hot to the touch when she picked it up and wouldn’t turn back on. The photos inside it – like many of my recent memories – were simply gone. I had just learned that I have cancer, and I was a wreck. It went like this: We left the beach and came home to Pittsboro midweek – Wednesday, I think it was. Friday I went to the doctor, curious about a lump on my neck. Saturday night I went to the hospital. Sunday morning I was diagnosed with chronic lymphocytic leukemia (CLL), which is such a rare diagnosis at 35 that my age range doesn’t even show up on statistical models. I can remember my trip to the hospital in crisp, precise detail, but my memories of the beach trip – and, indeed, much of summer 2017 – were eclipsed by what happened on August 12, which was the Saturday when everything started. And now, in August 2018, I’m looking the first anniversary of my leukemia diagnosis squarely in the face. I can’t really say how I’ll feel when
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August 12 comes, but I suspect I’ll be fine. See, not only am I alive, but I’ve had one of my best years. For one, my medicine works. I have a strain of CLL that doesn’t respond to traditional chemo and that was considered terminal less than a decade ago. Today, it is merely incurable – considering the alternative, that’s okay by me. I take a few pills every evening, and they have very quickly reined in my disease. The only thing I can’t do anymore is eat grapefruit. Why else has my year been so great? For one, I have a good crew: I married well and I have great kids, and I have a core of reliable friends as well. My close call reminded me that nothing is more important than surrounding yourself with good people who you value and who value you. Since diagnosis I’ve started taking better care of myself. I’ve cut my drinking by about two-thirds, and I’ve started working out daily. I’d like to pretend that I would have had the discipline to actually take these steps without a cancer diagnosis, but it is what it is. I’ve been a professional nonfiction writer since 2010, but since my diagnosis I’ve made a conscious effort to write fiction as well. I’ve always had short story and novel ideas floating around my head, but I never had any real success in putting them on the page. A few months after diagnosis, however, I added fiction to my deadline board, with 2,000 words due every two weeks. After many months of that, I’ve written a number of chapters in two sci-fi books and I hope to finish them by 2020. I can’t wait to share these stories. Speaking of writing, another thing I did after my cancer diagnosis was accept an exciting new job editing this very magazine. I got four new tattoos (I’ve wanted more tattoos for years, and these four new ones are only the beginning) and Rachel
and I went on the zipline course at the Nantahala Outdoor Center in Western North Carolina. It was worth it. It was so worth it. I discovered something during our ziplining trip. When I clipped into my harness and looked down from the first tower, I had zero fear. This is remarkable, because one reason I’d wanted to take the ziplining course was because of my fear of heights. I wanted it gone, and I figured ziplining from mountaintop to mountaintop would force it out of my system. Yet with a cancer diagnosis came a very real fear of death, and my theory is that it forced out all other fears in my life – including, yes, my fear of heights. I’ve tested this theory since, such as when we rode the Ferris wheel and the chairlift ride at the State Fair that October, and it’s confirmed: my fears are just plain gone.
my life and I am genuinely and sincerely as happy as I’ve ever been, if not happier. As for the memories I lost? I’ll make more. I have time.
I’m not afraid. I don’t feel sorry for myself. I don’t lose sleep. I stay positive, and it’s not a front. The way I see it, one of two things is going to happen. One: I’ll not have as long a life as I’d hoped, in which case there is simply no time to waste on worry, fear or self-pity; or two: I will live a normal lifespan, in which case I owe it to myself (and to all the people whose luck wasn’t as good as mine) to live without worry, fear or self-pity. Either way, fear is no longer relevant to my life. So why have I spent hundreds of words talking about myself? I want to illustrate a point: cancer doesn’t have to be the end. Yes, I know some forms are more aggressive than others and that many, many people don’t have the same treatment options I do. I simply happened into a form of cancer that is manageable by modern medicine, and I know I’m not alone. Not only does cancer not have to be the end for me, but it doesn’t even have to mean I’m unhealthy. Yes, I have leukemia, but I’m also in the best shape of
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Surviving & thriving Sherri Eder responded to a 2015 thyroid cancer diagnosis with grace and optimism that carry her to this day. by Corbie Hill | Photo by Diana Matthews
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It never really occurred to Sherri Eder that she could get cancer. She takes care of herself. She eats well. She stays fit. She doesn’t use bleach and she tries to stay away from chemicals. She gardens because she wants to know exactly what goes into her food. She always thought that made her immune. And then came December 2015, weeks before her 53rd birthday, when she was diagnosed with thyroid cancer. “It truly does not matter what you do in your life: how healthy you are, how much you exercise, if you’re vegetarian, if you eat organic, it does not make a difference,” says Eder, who is a billing specialist and vacation cottage property manager with Aging Outreach Services (full disclosure: AOS is OutreachNC’s parent company). “Anybody can have cancer. We’re all susceptible.” She says this matter-of-factly, though, and without self-pity or dread. Here’s one thing about Eder: she’s a pragmatist, and she doesn’t let could-have-beens occupy valuable space in her mind. Here’s another: she believes in educating herself, in researching her condition and making intelligent treatment decisions. And here’s yet another: she greets every day – even the rough ones – with an appreciation for the life she has rather than regrets about her disease. “Even if I have a headache, I’m like, ‘Thank you, Lord. You allowed me to wake up,’” Eder says. “There’s so many people I know who have had cancer who are not here today. Everyone’s touched by it, but not everyone’s blessed to be here.” Eder is a spiritual person, and her faith helps her stay grounded. She recognized early on that the future is largely out of her control, so she consciously gave that worry and concern to God.
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Beyond faith and prayer, she trusts her instincts. Eder knows how to keep herself physically healthy and well. In this way, she plays an active role in her treatment: she does her part, and the doctors do theirs. And then there’s mental self-care: traumatic news like a cancer diagnosis unleashes a cluster of complex emotions, and Eder gave herself time to process these feelings. “You need a year to mourn everything you’ve gone through,” says Eder. “Even though I didn’t feel [mournful] – I always stayed upbeat and joyful – you have to go through a certain process to come out the other side. I always knew I would.” The early days of Eder’s diagnosis were tough, but it wasn’t fear or anxiety about her own health that wrecked her. What was most difficult was telling her husband and grown children; her sisters; her dad, who had been diagnosed with cancer just the year before. “I felt bad about having cancer. That was the thing – I felt bad,” Eder admits. “I think it’s a mother role, being the oldest of five girls, the oldest sister – having to tell them that there was something wrong with me was very difficult.” From there, things looked up. Thyroid cancer treatment has advanced substantially in the past decade, Eder says, and her endocrinologist believes we are on the cusp of improving thyroid cancer survivors’ quality of life as well. And while Eder’s spirit is strong, there have been physical ups and downs. She recovered quickly after her thyroid was removed in January 2016, but eventually that caught up with her. Eder now takes Synthroid, a replacement hormone for people with a removed thyroid, and once her body adjusted to it her energy levels plummeted. It was the first time in this naturally energetic woman’s life that she knew what it felt like to be
simply wiped out and unable to recharge, and she spent a full year exhausted. Fortunately, since early 2018 she and her doctors have found a more appropriate dosage, and Eder’s energy level is back to what it should be. “Half a pill more or less every week makes all the difference between me being jittery or being so tired I feel like I can come home and sleep on the couch as soon as I get home for 12 hours, which is unusual for me,” she says.
thyroid cancer survivors and people touched by this disease. “I look at it as a privilege to be able to pass this information on,” she says. Eder may be reached at sherrie@ agingoutreachservices.com or at 910-692-0683.
Eder also received radioactive iodine therapy. Because of the radiation in the medicine, she had to quarantine herself at home. This meant staying in the guest room and having no contact with others for five days. She couldn’t cook, she couldn’t see her pets and everything she touched had to be double-washed, destroyed or stored for the three months it takes for the radiation to wear off. Fortunately, her quarantine coincided with a spring-like March week, so Eder spent most of it outside gardening. Indeed, optimism, faith and mental flexibility have allowed Eder to respond positively to trying circumstances: rather than bemoan her year without energy, she celebrates that she now has it back; and rather than spend her five-day quarantine feeling isolated and miserable, Eder spent it outside doing something she loves. And, finally, rather than let cancer change her or damage her spirit, Eder elects to not really think about it. “Most of the time, I’m just going to ignore it, pretend it’s not there and go on with life and be happy and joyful and laugh,” Eder says. “I don’t think I’ve really had any change in my personality. I did not allow it to make me down. I just acted like I didn’t have it.” If you have questions about thyroid cancer and its treatments, Eder is happy to speak with fellow
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Jessica Jane & Niels Duinker’s
Magic Variety Show
September 20 – 21
2018 – 2019 SEASON
The Music of John Williams
October 5
On Stage For Youth September 20 November 27 November 28 March 18
September 28
October 19 10th Annual
Three Musketeers Strike at the Wind! American Indian Storytelling & Dance Dar He: The Story of Emmett Till
October 27
Holiday Extravaganza November 30
Distinguished Speaker Series*
December 2 Martin Sensmeier Wes Studi Sept. 27 Nov. 19
Michael Dyson Jan. 24
January 12 Sleeping Beauty
Diane Guerrero April 16
SEASON SUBSCRIPTIONS NOW AVAILABLE!
February 20
March 11
The Red Hot Chilli Pipers
The Midtown Men
March 20
April 15
Get the best seats and discounted rates.
Call for group discounts and Act 1 Diner pre-show dinners.
910.521.6361 • uncp.edu/gpac *Shows and dates subject to change.
To register, contact:
910.692.0683
info@aosnc.com
DRIVING SAFETY FOR ADULTS 65+ safety tips & warning signs for older drivers
Visit with our panel of experts & driving solutions providers in an open discussion focused on driving safety.
Tuesday, Sept. 25 | 4:00 p.m. Seven Lakes Chapel in the Pines 581 Seven Lakes Drive | WEST END Doors Open at 3:00 p.m. for Registration & Light Refreshments
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Medicare:
What You Need to Know by Richard King There are three basic ways to get Medicare: One - from the federal government only (Original Medicare); Two – from the federal government and a private insurance company (Original Medicare plus a Medicare Supplement plan/Medicare prescription drug plan); Three – from a private insurance company only (Medicare Advantage Plans). Each way has some advantages and disadvantages, and which one is best depends upon your circumstances and what you’re the most comfortable with. Here’s a brief description of each way you can get your Medicare:
• A deductible of $1,340 per benefit period (you may have to pay more than once a year), which covers your first 60-days of care billed directly by the hospital.
Original Medicare consists of Part A (hospital coverage) and Part B (medical coverage). Depending upon what level of care you receive, you may use only Part A, only Part B or both. Neither Part A nor Part B cover outpatient prescription drugs. Also, there is no limit to how much you may have to pay each year. So, what’s covered by Original Medicare and what will it cost me?
• A copay of $167.50 per day for skilled nursing care on days 21 thru 100 (the first 20 days don’t have a copay).
Medicare Part A (hospital) covers inpatient hospital care (care received when you are admitted to the hospital as an inpatient). It also covers skilled nursing care and any medications you receive as an inpatient. Most people don’t pay any premium for Part A because they have met the 40-quarter requirement (basically, you paid taxes for at least 10 years). However, there are several costs that you will pay under Part A in 2018:
• A copay of $335 per day for days 61 thru 90. • A copay of $670 per day for days 91 thru 150 (your lifetime reserve days). There is no coverage after day 150 (after day 91 if you have already used all of your lifetime reserve days).
Medicare Part B (medical) covers your doctors and things not billed directly by the hospital (lab, x-rays, etc.). It also covers medications that aren’t self-administered (such as flu shots, pneumococcal pneumonia shots, etc.). There is a premium for Part B coverage. The standard premium (what most people pay) is $134 in 2018. However, people with an income over $85,000 as an individual or $107,000 as a couple will pay a higher premium. Part B also has an annual deductible of $183. Medicare Supplement plans (also called MedSup or Medigap plans) cover some or all of the copays and
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deductibles of Original Medicare, depending upon which plan you choose. There are ten standardized Medicare Supplement plans to choose from in North Carolina (Plans A, B, C, D, F, G, K, L, M and N). Because the plans are standardized, the coverage for a Plan A thru N from one company will be the same for all the companies offering the same plan (but not all companies offer all ten plans). However underwriting standards will vary from one company to another. Generally, the easier it is to qualify for coverage, the higher the premium. Medicare Supplement plans (except Medicare Select plans) do not have a network. If the provider accepts Medicare, they accept Medicare Supplement. The plan provides nationwide coverage, with your premium based upon where you live. It’s important to understand that everyone has a guaranteed issue period for Medicare Supplement insurance. This is a six-month period that starts when you first enroll in Medicare Part B. During your guaranteed issue period you can’t be turned down or rated up for any reason. However, if you miss the guaranteed issue period the insurance company can either decline to cover you or charge you a higher premium based upon your health. Medicare Supplement plans do not provide any coverage for outpatient prescription drugs (although some plans bought before January of 2016 may still provide prescription drug coverage). Most people who purchase a Medicare Supplement policy will also need a Medicare prescription drug plan. Medicare prescription drug plans (also called Medicare Part D) covers outpatient prescription drugs only. All Medicare prescription drug plans use a formulary (a list of the drugs covered). They have a network of pharmacies that participate and they have copays based upon a tier system (the lower the tier number, the lower the copay). The plans provide prescription drug coverage nationwide, but your premium will be based upon the state where you live. Technically, Medicare prescription drug plans are optional; However, you will usually have to pay a late enrollment penalty if you don’t enroll when you are first eligible, or if you go over 63 days without creditable coverage (such as an employer group plan). If you are charged a late enrollment penalty it lasts for the rest of your life! You can purchase a Medicare prescription drug plan with or without a Medicare Supplement plan. However, you cannot normally purchase a prescription drug plan with a Medicare Advantage Plan. There are four basic stages to a Medicare prescription drug plan:
• Deductible: If your plan has a deductible, that is the amount you will pay before the plan provides coverage. Your plan may or may not have a deductible. The maximum deductible in 2018 is $405. • Initial coverage: This starts after you meet your plan’s deductible (if it has one) and lasts until the total cost of your medications reaches $3,750 in 2018. The total cost is what both you and the insurance company pay for your medications. During this stage you will simply pay a copay for each prescription. • Coverage gap (donut hole): This starts once the total cost of your medications reaches $3,750 and lasts until your cost reaches $5,000 in 2018. In this stage you get a discount from the drug manufacturer so that you pay 35% of the cost for name brand drugs and 44% of the cost for generic drugs. Your cost includes only any deductible and copays you paid, plus the discount you get from the drug manufacturer: It does not include anything paid by your insurance company. • Catastrophic care: Once you reach this stage you will pay only a very small copay or co-insurance, usually about 5% for the rest of the year.
Medicare Advantage Plans (also called Medicare Part C) provide all of your Part A, Part B and usually your Part D coverages (although some plans without prescription drug coverage are available) in a single plan offered by the insurance company. In addition, many of the plans offer additional services (not covered by Medicare) such as vision, dental and transportation. To be eligible for a Medicare Advantage Plan you must have Medicare Part A and Part B, you must live in the plan service area (which may be an entire state or just a county) and you cannot have been diagnosed with end stage renal disease (kidney failure that requires dialysis or a transplant). When you select a Medicare Advantage Plan you are still enrolled in Medicare – however, you receive your coverage through a private insurance company. Therefore, your deductibles and copays are determined by the plan you chose, not by Original Medicare. Also, your doctors must submit all bills to your insurance company, not Medicare. All Medicare Advantage Plans place an annual limit on how much you pay for covered services. This limit will vary from one plan to another, even within the same company. Premiums for a Medicare Advantage Plan are smaller than premiums for a Medicare Supplement plan. However, you will have copays and
Don’t Miss A with Family & Friends!
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OutreachNC.com 55
co-insurance amounts with Medicare Advantage Plans that are normally higher than they are with Medicare Supplement plans. You aren’t allowed to have both a Medicare Advantage Plan and a Medicare Supplement plan at the same time. There are several types of Medicare Advantage Plans to choose from (not all companies offer every type of plan): • Health Maintenance Organization (HMOs) plans normally have a network of providers that you must use to get coverage. However, all Medicare Advantage Plans must cover medical emergencies and medically urgent care. Most HMO plans include prescription drug coverage. • Health Maintenance Organization Point-ofService (HMO POS) plans have a network but allow you to use some out-of-network providers for a additional fee. • Preferred Provider Organization (PPOs) plans have a network of providers but allow you to use out of network providers at a higher cost to you. Most PPO plans include prescription drug coverage. • Private Fee-for-Service (PFFS) plans allow you to see any doctor that agrees to accept the plan’s payment terms and agrees to treat you. A doctor may accept
the plan’s terms and treat you today but refuse to treat you next week. You need to ask if the doctor will accept this plan each time you use it. Many PFFS plans do not include prescription drug coverage. • Special Needs Plans (SNP) are available for some people, such as people in a nursing home, people who have both Medicare and Medicaid and people with specific conditions such as diabetes, HIV/AIDS and chronic heart disease. All SNPs include prescription drug coverage. About the Author: Richard King has been a life and health insurance agent since June of 1999 and has been a Medicare Supplement/ long-term care insurance agent since September of 2001. He has been certified to instruct insurance prelicensing and continuing education courses since December of 2004. King taught pre-licensing courses for life insurance, health insurance and Medicare Supplement/longterm care insurance for seven years and teaches continuing education classes in these subjects. He is currently an independent insurance agent. Richard can be reached at 910-977-3118.
All Fruits and Vegetables Available! Tomatoes, Green Beans, Fruits, Veggies, Jams, Meats, Flowers & Plants, Crafts, Chicken, Eggs, Beef, Pork, Ostrich Meat, Baked Goods, Prepared Foods, Goat Cheese, Watermelons, Peaches, Blueberries, Cantaloupe, Egg Plant and Micro Greens FirstHealth
(Fitness Center)
170 Memorial Drive | Pinehurst 2 pm - 5:30 pm Open through 10/29
56
OutreachNC.com | AUGUST 2018
Armory Sports Complex 604 W. Morganton | So. Pines 9 am - 1 pm Open Year Round
www.moorecountyfarmersmarket.com
Downtown Southern Pines Broad Street & New York Avenue 8 am - 12 Noon Open through 10/27
4
A quick look at your Medicare coverage choices
There are 2 main choices for how you get your Medicare coverage. These choices will be explained in more detail on the next page and throughout this book. Option 1:
Option 2:
Original Medicare
Medicare Advantage (Part C)
(See pages 61–64) This includes Part A and B.
Part A Hospital Insurance
(See pages 65–78) These plans are like HMOs or PPOs, and typically include Part A, B, and D.
Part A Hospital Insurance
Part B Medical Insurance
You can add:
Part B Medical Insurance
(See pages 83–96)
Part D Medicare Prescription Drug Coverage
You can also add: (See pages 79–82)
Part D Medicare Prescription Drug Coverage (Most plans cover prescription drugs. If yours doesn’t, you may be able to join a separate Part D plan.)
Medigap Medicare Supplement Insurance (Medigap policies help pay your out-of-pocket costs in Original Medicare.) AUGUST 2018 |
OutreachNC.com 57
5
Things to consider when choosing your Medicare coverage These topics are explained in more detail throughout this book. Original Medicare
Medicare Advantage
There’s no limit on how much you pay out-of pocket per year unless you have supplemental coverage.
Cost
Plans have a yearly limit on your outof-pocket costs. If you join a Medicare Advantage Plan, once you reach a certain limit, you’ll pay nothing for covered services for the rest of the year.
Medicare covers medical services and supplies in hospitals, doctors’ offices, and other health care settings. Services are either covered under Part A or Part B.
Coverage*
Plans must cover all of the services that Original Medicare covers. Plans may offer benefits that Original Medicare doesn’t cover like vision, hearing, or dental.
You can add a Medigap policy to help Supplemental pay your out-of-pocket costs in Original coverage Medicare, like your deductible and coinsurance.
It may be more cost effective for you to join a Medicare Advantage Plan because your cost sharing is lower (or included). You can’t use (and can’t be sold) a Medigap policy if you’re in a Medicare Advantage Plan.
You’ll need to join a Medicare Prescription Drug Plan to get drug coverage.
Prescription drugs*
Most Medicare Advantage Plans include drug coverage.
You can go to any doctor that accepts Medicare.
Doctor and hospital choice
You may need to use health care providers who participate in the plan’s network. If so, find out how close the network’s doctor or pharmacies are to your home. Some plans offer out-ofnetwork coverage.
You can get a snapshot of the quality of care health care providers (and facilities) give their patients by visiting Medicare.gov.
Quality of care
The Medicare Plan Finder at Medicare.gov/find-a-plan features a star rating system for Medicare plans.
Original Medicare generally doesn’t cover care outside the U.S. You may be able to buy supplemental insurance that offers travel coverage.
Travel
Plans usually don’t cover care you get outside of the U.S.
* If you have other types of health or prescription drug coverage, check to see how it works with the type of coverage you’re considering before you make any decisions or changes. 58
OutreachNC.com | AUGUST 2018
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OVER MY SHOULDER
Golden Years Time Management:
life
Retirement requires as much day-planning as life in the workforce
by Ann Robson One of the myths about retirement is that you’ll have all the conflict with a doctor’s appointment. Medical engagements time you ever wanted to do whatever you wanted. No more will become a regular part of your new life if you want to keep getting up at the crack of dawn to go to work. No more getting enjoying that life well into retirement’s “golden years;” thus, home just in time for dinner. No more spending the weekend you need to plan accordingly. catching up on household chores. Now you have time to spare. In our home we have a calendar on the side of the refrigerator Ask anyone who’s been retired more than a few months what to record comings and goings. If something is not on that they do with their time now and you’ll be surprised to hear calendar, then it probably doesn’t happen. With two people who they are so busy they wondered how they ever had time to have different interests and demands, that calendar keeps us in work. At first, retirement seems like it should be a vacation order. Beyond that, we tend to fulfill household requirements that never ends. However, life goes on and mundane things on a regular, but not regulated, basis. Something that doesn’t like laundry, housecleaning, mowing the lawn and watering get done on Monday may have to wait two or three days. That the garden need to be done. said, if it’s important to a comfortable living condition, it does On the positive side, you now have the freedom to choose get done. Social events and volunteer work can now have more when you’ll do these tasks. You can even put some things of our time, so they tend to take precedence over doing the off and off and off. As with every choice you make, there are laundry. consequences, so delaying regular maintenance will eventually One of the websites made the statement that time is not “just catch up with you. Instead of spending a reasonable amount about getting things done right, but getting the right things of your time on such tasks, you’ll have to spend an inordinate done.” I found that to be an impressive motto. It offered amount of time. suggestions for time management that appear to be universal: I decided to check out “time management” as a topic on have a planning tool, budget time, get organized, have a the internet. There are copious suggestions: six tips for time strategy for scheduling, learn to delegate, practice saying “no.” I management; seven tips for organizing your time; 11 strategies agreed with all but the getting organized step – most of my life for time management. There were suggestions for almost is organized but my desk is not. I live by the motto “Creative every category of people from students to office managers, minds are rarely tidy,” and my work desk is living proof, but my but nothing for retirees. I was quite offended that the business time is very well managed. types assume that once we have retired we have fallen off the grid, never to be heard from again. Ann Robson is the author of “Over My I believe a case can be made for time management for those of Shoulder: Tales of Life and Death and Everything In Between.” She can be us who are retired. We need to plan our days just as carefully reached at overmyshoulder@charter.net . as when we were in the workforce. We can’t have our golf game
AUGUST 2018 |
OutreachNC.com 61
GREY MATTER See Grey Matter Puzzle Answers on Page 64 Puzzle 8 (Medium, difficulty rating 0.52)
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ACROSS 1. La ___, Italian opera house 6. “Hamlet” has five 10. “Ashes to ashes, ___
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OutreachNC.com | AUGUST 2018
17. Express 18. Gulf V.I.P. 19. “Your majesty” 20. Professed 22. Farm equipment
DOWN 1. “Beat it!” 2. Beanies 3. Came down
Gang Gear Golden Goods Hers Idle Keeps Kept Kids King Lack Lies Limb Lion Lips Look Loosen Mile Milk Move Mugs Needed Older Peak Pets Pieced
Rake Ring Rule Safer Scar Side Smacks Smoked Snake Sock Solo Test Tyres Uses Very Video Vine Vocal Wrap
4. “The ___ Ranger” 5. About 6. Anticipated 7. Armed fighting 8. Warbled 9. Arid 10. Medical clinic 11. Handy 12. New England catch 13. Muscular strength 21. Cold war foe 24. Social 25. Attempt 26. By way of, briefly 27. Checked out 28. Portent 30. Change the look of 32. Bread spreads 34. “Empedocles on ___” (Matthew Arnold poem) 35. “Heartbreak House” writer 36. Be a snitch 40. Shut off 41. Heartfelt 43. Bat droppings 45. Golden Horde member 46. Certain Arab 47. Harbors 49. “Hurray!” 51. Agenda 52. Not yet final, at law 53. Beam 54. Onion relative 55. Blows it
GREY MATTER
In honor of our “Living Healthy” issue, here are some extra “Brain Exercises” to keep your Grey Matter in tip-top shape!
See these Grey Matter Puzzle Answers on Page 65
An IMPOSSIBLE Brain Teaser This brain teaser is really not impossible, but it is tricky! Carefully read the directions in each line to make changes in the previous set of letters. Write the new letters in the blank after each instruction. The first two are completed for you. 1. Start with IMPOSSIBLE.
IMPOSSIBLE
2. Change the second vowel from the left to E.
IMPESSIBLE
3. If occurrence is spelled correctly, change the 2nd consonant to H. If it is not spelled correctly, change the last consonant to T.
_____________________
4. Omit the letters, in order, that spell MESS.
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5. Insert CABBAGE after the 1st vowel.
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7. Move the first vowel so that is directly to the right of the 4 consonant.
_____________________
8. If mischieveous is spelled correctly, omit the first two letters. If it is spelled incorrectly, omit the double consonants.
_____________________
th
9. Change the G to V. _____________________ 10. Switch the places of the 2nd consonant and the 3rd consonant.
_____________________
11. If occasionally is spelled correctly, omit the 2nd letter. If is spelled incorrectly, add IN after the first letter.
_____________________
12. Switch the order of the 1st and 2nd letters.
_____________________
13. If your letters now form a correctly-spelled word, write them in the blank below. If not, review the directions to find any possible errors. Name: Solving this brain teaser is not IMPOSSIBLE. It is _______________________ ! Created with TheTeachersCorner.net Word Search Maker
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Abdominals Alveoli Asthma Biceps Bones Bronchi Calories Cancer Carbohydrate Carcinogen Carpals Cartilage Cheekbone Cilia Clavicle Cold Deltoids Epiglottis Facial Fats Femur Fibula Flu Forehead Fruit Hamstrings Hip Jawbone AUGUST 2018 | Ligaments Lungs
Marrow Metacarpal Metatarsal Minerals Mouth Nasal Nose Obliques Patella Phalanges Protect Protein Quadriceps Radius Ribs Skeleton Skull Sodium Sternum Support Tarsals Thoracic Tibia Trachea Triceps Ulna Vegetables Vertebrae OutreachNC.com 63 Vitamins
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7 5 1 8 4 9 2 3 8 3 2 1 4 7 6 9 When you let us organize the5paperwork and set up an easy system for you to monitor, you 4get more time to0.54) enjoy your life5 and family. Puzzle (Medium, difficulty rating Puzzle (Medium, difficulty rating 0.59) 8 become 1 7 2 6your 5 trusted 9 3 8 4 Manager 7 5 1 2 9 6 We4 will Daily3Money 7 3 the 5 stress 9 8 of 1 your 4 6 day-to-day 2 2 finances 7 1 9 from 3 6 your 4 8 5 relieving 6 9 2 4 5 already 3 7 1 hectic 8 life.9 6 5 4 2 8 7 1 3 3
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Daily Money Management Solutions 2 5 9 3 1 4 6 8 7 1 2 9 3 7 4 6 5 8 Personal Financial Management | Bill Paying Services 1 7 8EDCNB 5 6 9- Makes 3 2 4Your Life...Easier! 6 3 7 5 8 9 1 2 4 910-683-0330 5 2 6 1 3 7 8 4 9 7 4 2 8 9 5 3 6 1 APSeline@EDCNB.com 9www.EveryDayChecksAndBalances.com 1 7 6 4 8 2 3 5 5 9 3 1 6 7 8 4 2
GREY MATTER ANSWERS
CROSSWORD
WORD SEARCH
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Looking Ahead
Puzzle 10 (Medium, difficulty rating 0.54)
Puzzle 11 (Medium, difficulty rating 0.54) Don’t miss out on getting your monthly copy of
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READER INPUT
In July, we introduced you to the poetry of Barbara Stoughton. This Southern Pines retirement home resident processes her change from independent living to a new way of life through verse, and we at OutreachNC are pleased to share her poetry. Pour yourself a cup of tea, take a deep breath, and read on. “A Plea to Cardinals” Today, I see the cardinals fly. But now – this contrary feeling, nd the waywardness – in the constant missing of my past way of living, that was woven freely in the open air, I could breathe.
I don’t see how to prevent its being. I’ll have to fit it in somehow. So in fitting in, I can breathe more freely. Perhaps the cardinals flying by can show me how. I’ll just fly with them awhile. * From an artist getting used to a retirement home way of living hopefully and I have. -Barbara Stoughton
Must I now learn complacency, just so I can fit inside? Can I take my imagination Into this new way of living?
If you have any thoughts or suggestions you’d like to share, contact OutreachNC editor-in-chief Corbie Hill at editor@outreachnc.com or at PO Box 2478. Southern Pines, NC 28388.
GREY MATTER ANSWERS An IMPOSSIBLE Brain Teaser Answers 3. IMHESSIBLE 4. IHIBLE 5. ICABBAGEHIBLE 6. ICABBAGEHABLE 7. CABBAGIEHABLE 8. CAAGIEHABLE 9. CAAVIEHABLE 10. CAAHIEVABLE 11. CAHIEVABLE 12. ACHIEVABLE
Name: Created with TheTeachersCorner.net Word Search Maker
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SAUGUST C A R
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L S I S C S R OutreachNC.com 65
Generations
by Corbie Hill & Michelle Goetzl
OutreachNC asked adults and children our August question. Share your answer on our Facebook page.
What is your favorite activity to do with a friend? I like to watch movies – Gianluca, 13
I like to play with Play-Dough – Mary, 9
Laugh and talk. – Wiley, 88
Make a fort! – Olivia, 9
I LIKE PLAYING BATTLESHIP – NOAH, 11
Watch TV football. – Ed, 88
Play hide and seek – Mariska, 7
Hula hooping – Callie, 9
Play bridge at the club. – Ethel, 79
Ballroom dance with my husband. – Beverly, 80
Dine. – Gary, 92
I like kitten around with my friends. – Jeeves the cat, 5
Have a parade – Evelyn, 7
I like to do gymnastics – Malia, 8
I like to play Slamwich (a card game) with my friends! Grayson, 10 Line dancing. – Hilda, 76 Write music. – Corbie, 36 Build with Legos – Violet, 8 Lunch [and] shopping. – Joan, 85 Go swimming together – Sydney, 6 Yard sales. – Carol, 74 I like to do four square with my friends – Holli, 10
If you would like to submit an answer for an upcoming question, please email editor Corbie Hill at editor@OutreachNC.com. Please be sure to include your first name and the age you will be the month that issue runs. THE UPCOMING GENERATIONS QUESTIONS ARE... September: If you could| AUGUST be a bird,2018 which one would you be? 66 OutreachNC.com
| October: What is your favorite Halloween costume?
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OutreachNC.com 67
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68
OutreachNC.com | AUGUST 2018
866.573.4909