The Sounds of Summer
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I love the Sounds of Summer!
When I hear those familiar sounds, great memories of past summers flood my mind. Growing up in San Francisco, a city bursting with noise, every Fourth of July was special. Despite the typical cold, foggy July days, when my dad fired up his tiny hibachi grill, and I heard the sizzle of hamburgers, it felt like the hottest summer day.
After 35 years in sunny San Diego, I’ve more than made up for those chilly summers. Yet, something as simple as the sizzle of a grill brings back wonderful memories. Today, I look forward to the steady tap of feet on a dock in Maine and the screen door opening and closing during a dinner party—sounds that announce summer has arrived, surrounded by beloved family and friends. Great memories don’t take much to evoke. I hope you listen for your best summer memories, too.
The
Longest Day
Summer Solstice on June 20th is “the longest day of the year,” a day we also bring light to the darkness of Alzheimer’s. If you have a loved one living with dementia or are a caregiver, know you’re not alone. We all need support and respite when caring for someone with dementia. It’s a long journey to go it alone, so please ask for help.
The More You Know
Exciting things are happening in aging today. Harnessing the Power of Exercise: A
Game-Changer in Parkinson’s Management (pg. 6) is one such innovation. Parkinson’s affects over 1 million people in the U.S., and specific exercises are crucial in managing this disease and improving gait, balance, mood, cognitive function, and more. Read about Lee’s incredible journey, which started in 2015.
Say It Isn’t So…
The Average American celebrates only one healthy birthday after 65. I’m not sure I agree. Many people are healthy, well past 65. As Boomers and the oldest Gen X enter their 60s and 70s, many are making choices to live and age better. The current aging adult wants to live well, and it starts with giving yourself permission to age well. Let’s change the narrative that we get sick after a certain age. Even when faced with disease, decide to take control of your journey.
I Caved
I reluctantly signed up for a TikTok account to check out the five Boomers behind @RetirementHouse, who boast 5.7 million followers. The Gen Zs must be green with envy at those social stats. Their motto, “Live Bold, Not Old,” is one of many quippy TikToks they’ve created. Kudos to the Boomers for continuing to be mavericks—well done!
Age Well.
Jacqui Clark, CSA Editor in Chief Aging Well Magazine
Jacqui Clark is a Certified Senior Advisor™ (CSA™) consultant with Living Coastal Senior Resources. She is an industry-leading livingand-aging well expert and a respected communications specialist. Jacqui@ LivingCoastalSR.com www.ThisIsLivingWell.com
The Sounds of Summer in this issue: A New Bandage on an Old Problem, Age Gracefully with Breathwork , From Emergency Physician to End of Live Care , Getting Long Term Care Insurance to Pay, Harnessing the Power of Exercise , Professional Fiduciaries, The Power of Music , Transportation: A Vital Social Determinant of Health, Unveiling the Tapestry of Your Family Heritage , Writing Your Way Back to Yourself After Loss, The Biggest Mistake in Aging, and more….
Harnessing the Power of Exercise: A Game-Changer in Parkinson’s Management
A Neurologic Physical Therapist’s Perspective on Parkinson’s Disease
In the intricate landscape of Parkinson’s disease management, one factor shines brightly as a beacon of hope: Exercise.
As we navigate the challenges this progressive neurological disorder poses, tailored exercise regimens emerge as a key player in enhancing the quality of life for those affected.
As a physical therapist with years of experience working with clients and patients with neurologic impairments, I am passionate about sharing exercise’s transformative potential in Parkinson’s care.
The National Perspective Parkinson’s disease affects over 1 million individuals in the United States alone. With projections indicating a doubling of this number by 2040, the urgency to innovate approaches to management becomes ever more pressing, as highlighted by the Parkinson’s Foundation. Across the country, communities grapple with the impact of Parkinson’s, seeking effective strategies to alleviate its burdens.
Our Local Impact: San Diego, California
Here in San Diego, the prevalence of Parkinson’s disease also
resonates deeply within our community. According to the Parkinson’s Association of San Diego, an estimated 18,000 individuals are navigating the challenges of this condition. Comprehensive care for individuals, their significant others, and caregivers is paramount.
The Transformative Power of Exercise
The great news is that amidst the complexities of Parkinson’s management, emerging research illuminates an accessible path forward: EXERCISE!
Tailored exercise programs, specifically designed to address the multifaceted symptoms of Parkinson’s, offer a ray of hope for those grappling with its challenges. Studies conducted nationwide reveal compelling statistics, showcasing the myriad benefits of exercise for individuals with Parkinson’s:
• A staggering reduction of up to 70% in the risk of falls
• Improved gait and balance, fostering enhanced mobility and independence
• Mitigation of stiffness and rigidity, facilitating greater ease of movement
• Augmented mood and cognitive function, bolstering overall well-being
Embracing this Paradigm Shift
It is imperative that we embrace the transformative potential of exercise because, beyond mere symptom alleviation, exercise empowers individuals to reclaim agency over their health, fostering resilience and hope in the face of adversity. Key components for Parkinson’s Mobility & Health include exercise regimens that can address any or any combination of the components below:
• Aerobic Activity
• Strength Training
• Balance, Agility & Multitasking
• Flexibility
• Skill-Based Functional Mobility
• Dual Tasking for Cognitive Health
• Large Amplitude Based Activity
• Targeted Intensity
Not Sure How to Begin? See a PT!
If you aren’t sure what kind of exercise you need, the best place to start is to schedule a one-on-one evaluation with a licensed physical therapist. Preferably a therapist with neurologic experience; however, any physical therapist can assess your current functional mobility and determine how to achieve your goals. An evaluation will consist of an interview and assessment of your movement abilities, motor control and coordination, strength, and balance. Your PT may ask you questions about current functional levels, what medications you are taking and when you take them, and what symptoms you may experience, like freezing, tremors, problems concentrating, or fatigue.
All of your information and movement data will be collected to create an individual plan of care using evidence-based methods. Your PT can give you specific recommendations for exercises to do at home or the kind of classes you should look for, whether or not you would benefit from seeing your PT for more skilled sessions, and how often to return for a PT check-up. Even better news is that your insurance may cover your PT Evaluation and any subsequent sessions, so it’s always a good idea to check.
From personal experience, I have evaluated and treated persons with Parkinson’s who began therapy unable to walk or get out of bed or the chair without assistance from someone to become fully independent by using proven strategies and therapy specific to this diagnosis.
Consider the inspiring story of Lee, one of the first clients at Physio on the Go. Diagnosed with Parkinson’s disease in his 50s, likely a result of his service as an engineer during the Vietnam War, Lee faced increasing challenges as his symptoms progressed. By his 60s, severe tremors necessitated a deep brain stimulator. He was fortunate to have family support when he began with us in his 70s after moving to California to be closer to his sons and grandchildren. Still, he struggled with rigidity, balance, and managing his Parkinson’s medications. Thankfully, Lee and his sons found a part-time caregiver to assist with these challenges and provide transportation.
Lee connected with Physio on the Go through a recommendation from his son’s friend, a former patient of our founder, Sean. They began their partnership in 2015. Initially, Lee faced significant challenges with movement initiation, requiring tactile guidance for simple tasks like walking and turning, which significantly impacted his independence. However, through consistent, weekly sessions since then, there has been a remarkable improvement in Lee’s movement tolerance, flexibility, strength, and cardiovascular endurance. Moreover, the progression of his Parkinson’s has slowed significantly, allowing him to manage daily activities independently. Now, Lee enjoys walks, nature hikes, attending social and sports events, and traveling to see family during the holidays. He recently shared how these changes have made him feel like an active, contributing family member rather than a burden.
At Physio on the Go, we do more than treat symptoms; we serve as a healthcare liaison for our clients, advocating for their needs, continuously monitoring for medical issues, and coordinating with specialists. Our goal is to help clients like Lee reclaim their lives and independence, offering a holistic approach that fosters long-term relationships with them and their families. It’s a role we find profoundly rewarding.
As physical therapists, we are proud to champion the power of exercise within our community as a catalyst for change and a cornerstone of wellness in the fight against Parkinson’s disease. Exercise enhances independence and participation in activities that bring joy.
Photo(s) by Parkinson Wellness Recovery | PWR! - pwr4life.org
Dr. Rosalia Arellano is a boardcertified Clinical Neurologic Physical Therapist with 23 years of experience in neurologic and geriatric therapy. She holds certifications as a Parkinson’s therapist in Wellness Recover Moves (PWR! MOVES) and Lee Silverman Voice Treatment (LSVT BIG). She is a Clinical Faculty member for the SDSU Doctor of Physical Therapy Program.
Sean Kuhn, PT, DPT, FAFS, 3DMAPS, MBA, owns Physio On The Go, specializing in helping aging adults maintain their physical health and mobility through in-office, mobile, and online physical therapy and wellness services. Their licensed and experienced therapists can provide individualized assessments and personalized exercise plans to help you stay active and pain-free. Find out more: Live Beyond Parkinsons: https://bit.ly/live-beyondparkinsons www.physio-on-the-go.com (619) 391-8688
A Path to Vitality Age Gracefully with Breathwork
Imagine a practice that could rewind time, fill your veins with boundless energy, and vanquish stress from your life. Sounds too good to be true? Prepare to be amazed because the key to unlocking these age-defying wonders is literally under your nose. It’s called breathwork, and it’s about transforming the way you age.
Let’s get straight to the point: if you’re over 50 and not practicing breathwork, you’re missing out on the fountain of youth. With over four years of personal experience, I can attest to its transformative power. It’s not just about feeling a little more relaxed or getting a temporary energy boost; it’s about rewiring your entire being for optimal health and vitality.
Let’s talk energy. Remember those days when you felt unstoppable? Breathwork can bring those days roaring back to life. Take coherent breathing, for example—inhaling for five counts, exhaling for five counts for just five minutes. It’s like plugging yourself into an energy socket and feeling the surge through your veins. Say goodbye to afternoon slumps and hello to boundless vitality.
But it’s not just about feeling energized; it’s about keeping your heart ticking like a welloiled machine. High blood pressure may seem inevitable with age, but it doesn’t have to be. According to a meta-analysis of 15 studies, breathing exercises can have a modest but significant effect on lowering systolic and diastolic blood pressure. Some studies have found that regular breathing can reduce blood pressure as much as medication. Imagine effortlessly keeping your blood pressure in check without relying on a cabinet full of pills.
Now, let’s talk about stress—the silent killer lurking in the shadows of our lives. Breathwork is your secret weapon in the battle against stress. Coherent breathing flips the stress switch off by activating your body’s “rest and digest” mode. It triggers a cascade of changes that promote relaxation, lower heart rate, and reduce muscle tension. So, say goodbye to sleepless nights and racing thoughts and hello to inner peace and serenity.
I understand you’re busy, but you can’t afford not to make time for breathwork. It’s not just a
luxury; it’s a necessity for anyone who wants to age with grace and vitality.
So, here’s my challenge: carve out just five minutes daily for breathwork. Commit to it, whether first thing in the morning, during your lunch break, or before bed. Experience the transformative power firsthand.
Breathwork isn’t a fad; it’s a scientifically proven tool for unlocking the full potential of your body and mind. So, take a deep breath, exhale all your doubts, and dive into the world of breathwork. Your future self will thank you. Join me on this journey, and together, let’s unlock the secrets of breathwork and unleash the full potential of our bodies and minds. Your best years are yet to come—breathe them into existence.
Coherent Breathing
1. Find a comfortable seated position.
2. Close your eyes and settle into your body.
3. Inhale deeply through your nose for a count of five.
4. Exhale slowly through your nose or mouth for a count of five.
5. Repeat for five minutes, focusing on the sensation of your breath.
6. Open your eyes and observe how you feel.
7. Carry this calm and vitality with you throughout your day.
Brandon G. Handley, Certified SOMA Breathwork Instructor and founder of WellSpirit empowers individuals to harness the transformative power of breathwork for physical, emotional, and mental wellbeing. brandon@wellspirit. space https://wellspirit.space
Serving the 50+ Community in San Diego County
San Diego Oasis is an award-winning nonprofit organization that has been serving people 50+ throughout the San Diego region for the past 35 years.
Our mission is to promote successful aging through a three-fold approach:
• Lifelong Learning
We hold classes throughout San Diego County in 3 formats: in-person, hybrid, and online.
• Healthy Living
We offer sessions in fitness, dance, nutrition, life-style, and chronic disease management.
• Intergenerational Programs
We have hundreds of trained volunteers who dedicate their time to at-risk youth through reading tutoring, book giveaways, and mentorship programs.
Ways to Participate
• Become a Member (it’s free!)
• Sign up for classes
• Become an Elementary Student Tutor
• Become a Donor
• Volunteer at our La Mesa location
• Volunteer at our Rancho Bernardo location
• Rent space for your next party or meeting
• Advertise in our catalog
To learn more about these opportunities, send us an email at Info@SanDiegoOasis.org San Diego Oasis is a 501(c)3 public charity:
(Don’t)
Act Your Age
At every phase of your life, look at your options. Please, don’t pick the boring ones.
—Barbara Hillary, retired nurse, who skied to the North Pole at seventy-five years old
I dropped into author Caroline Paul’s book-signing at Warwick’s of La Jolla for her new book, Tough Broad: From Boogie Boarding to Wing Walking―How Outdoor Adventure Improves Our Lives as We Age (March 2024, Bloomsbury). About 100 people, including the Wave Chasers, a local boogie-boarding group in their 60s to 90s, squeezed into this iconic bookstore. They earned a chapter in the book.
I chatted with Paul, who had participated in the outdoor adventures she’d written about. She promotes five pillars for fulfilling aging: community, health, novelty, purpose, and a positive mindset. She also highlights the benefits of outdoor activities, challenging aging stereotypes, and the medicinal benefits of nature.
I loved reading this book! I believed there was an expiration date on participating in certain sports once you hit a number on your birthday cake, but I am delighted I was wrong. It was precisely the mindset we at Aging Well Magazine believe to be the cornerstone of living your best life.
At 61, she’s showing no signs of slowing down. And by the way, that’s Caroline on the wing of the biplane on the cover. Now, that’s what I call Aging Well!
Jacqui Clark, CSA Editor, Aging Well Magazine
* The following is an adapted excerpt from the book Tough Broad, reprinted with permission from Bloomsbury, the publisher. Make Waves (Together)
There is a whoosh of sound, like an oncoming train. The wave has broken and tumbles toward me in a white frenzy. The water is shallow, so I’m crouched awkwardly. The plan is to push off the ocean floor
at just the right time, then be carried to shore while clinging prone to a small floatable cafeteria tray called a boogie board. As the white-water approaches, I quickly recount the tips I’ve been given and replay what I’ve gleaned from watching those on all sides of me—point the board to shore, and when you feel the pressure on your thighs/butt/lower back (one of those, but I’m not sure which), push off. Drop belly onto board. Get weight forward. Hold on. Laugh hysterically.
I’m here in the San Diego surf with about twelve women, mostly in their sixties and seventies, one even in her eighties, who meet multiple times a week on this wide sandy beach to boogie board. I’m interested in why they’re so passionate, almost evangelical, about an activity I had barely given much thought to, a sport with aspects of frivolity and play I equated only with those under ten years old, not with women who I imagined might have been made somber, possibly even curmudgeonly, by life and age.
We meet on the sand, all of us in wet suits, me clutching a borrowed board with booties that are too big for my feet. The women are welcoming, friendly, and energetic; they introduce themselves in turn. It’s winter, and the water hovers at a frigid fifty-seven degrees. The air is usually cold for this Southern California beach, but that doesn’t faze anyone around me.
The size of the waves does give them pause, however. Not because they’re too big, but because they’re too small. There has been a bit of sighing and murmuring about this, much as a bunch of teenage surfers might lament that it just wasn’t gnarly enough out there. Unlike their
young counterparts, however, these women seem sure that they’ll have a good time no matter what. They’re mostly worried that in mild conditions like these, I won’t understand the true exhilaration of their beloved activity. Will I? I am still puzzled about its allure, but it is clear to me that something about boogie boarding exerts a deep and existential pull. Otherwise, these women wouldn’t be out here, much less come regularly multiple times a week.
The group’s founder is seventy-five-year-old Fran Dyer. Fran tells me that, unlike many outdoor sports, you don’t need a lot of money to partake. Perhaps it is this very demeanor—genial, inclusive, a pickleball of the water—that accounts for much of boogie boarding’s magic: it has none of the complexities that adults layer onto the world. This simplicity lays bare boogie boarding’s best asset: pure kidlike fun. As Fran explains, it’s a chance to shout “Yay!!!,” which you wouldn’t otherwise. You can yell and scream all you want because the ocean is louder than you. Also, the telephone doesn’t ring, you don’t talk about serious things, and no pressure on anyone.”
Fran is the perfect boogie board leader, setting this tone of inclusivity and acceptance. Fran explains that as older women face life changes like retirement, illness, the demise of a marriage, the death of a spouse, they begin to look for adventure and novelty, as well as likeminded friends, all of which this humble ocean activity offers. Fran herself is full of vim and vigor. “Twenty years ago, I thought [seventy-five] was ancient, but I don’t feel ancient. I’m still willing to try a new adventure. There are a lot of women willing to do that.”
This is a revelation to me. I have been on this quest preloaded with the belief that older women don’t want adventures, even as I’ve been ferreting out examples of women who embrace exhilaration in the outdoors with the enthusiasm of any twenty-fiveyear-old.
However, here is a line of older—even, dare I say it, elderly—women decked out in sun hats, full-body wet suits, and booties. The freezing ocean is at their elbows, and the cold wind is on their faces. Each looks vaguely like a Marvel superhero scanning the horizon for their next wave.
Loraine Vaught, sixty-two, joined the group two years ago. Partly, it was the pandemic and the need to feel less cooped up. Mostly, though, her fifties had been, as they are for many women, a time of difficult change. “The fifties are so difficult,” she tells me with a shake of her head. “You lose a lot of your confidence.” The decisive blow was when her sister died at fifty-seven years old. It was heart-rending and an eye-opener. “I told myself, I better get going.”
But get going where? How?
I’m unable to probe further because a wave is incoming. The white water hits, and I push off. Some unseen power lurches me shoreward. The sudden
speed is heart-quickening. Water taps my face—Look at you, here, at once a ten-year-old and an almost sixty-year-old. I laugh out loud. Moving with me on the same wave are Loraine to my right and Patricia Coe, a retired nurse practitioner, age seventy-five, on my left. These conditions are easy for them, but both are smiling widely anyway. It is my first wave, and I now understand much of what the women have been saying. For a moment, at least, I was completely focused. I was deep in play, exhilarated by the speed, immersed in nature—literally immersed in it.
There are many types of play—object play, imaginative play, social play, among others. Boogie boarding is those, but it is specifically “rough-andtumble play.” Much like the full-tilt, chaotic, joyous mock fighting of dogs at a park, many of the playful aspects of being on the waves are in the physical sensations—the cold temperatures, the churning water, the sudden, surprising speed.
We can shed so much of our overcivilized selves when we boogie board. This can hold appeal for women who have been girdled so long by society’s constant evaluations and keen attention on our sexual attractiveness, our child-rearing, our careerfamily balance, and our general demeanor. It is at a later stage in life when those aspects have diminished in currency, and we have instead been dropped into a grayer area that boogies boarding can reorient and guide us. And free us. No wonder it has been such a life changer for so many on these San Diego waves this morning. It is a wild, unruly, at once very personal and deeply social expression of play, offering brain-firing, body-engaging, communitybuilding fulfillment.
“The opposite of play is not work,” researcher Stuart Brown says. “It’s depression.”
Aging is a lonely business, we are told, yet here at the Newcomers Club, Wave Chaser division, that isn’t evident at all; everyone is milling around, ready to go have coffee now that the session is over. Loraine notes that even more than a whole string of discoveries—that she loves the ocean, that she can actually embrace the cold, that she now comes to the beach three times a week just for the thrill of a wave—she was most completely bowled over by how much the community aspect of boogie boarding came to mean to her.
I am humbled by how completely I had underestimated the power of a simple outdoor activity like boogie boarding, especially when it is done in community. Now boogie boards are being swept of their sand, booties pulled off, and the talk is already of the next session. Maybe there will be warmer weather, less wind, bigger waves. Or maybe not. The Wave Chasers will be here anyway, in their neoprene, looking like superheroes and kids and grandmothers all at once.
“The opposite of play is not work,” researcher Stuart Brown says. “It’s depression.”
Caroline Paul is the New York Times bestselling author of THE GUTSY GIRL. A longtime member of the Writers Grotto, she lives in San Francisco. www. carolinepaul. com. Her book is available at all bookstores and online.
Transportation: A Vital Social Determinant of Health
Transportation is a critical factor influencing health outcomes, and it is recognized as a social determinant of health (SDOH). The Centers for Disease Control and Prevention (CDC) defines SDOH as the conditions in which people are born, live, learn, work, play, worship, and age—factors that significantly impact health, functioning, and overall quality of life. Here’s why transportation matters:
1. Barriers to Medical Care:
• 3.6 million people in the United States annually miss out on essential medical care due to transportation challenges.
• Missed wellness checks and follow-up appointments can lead to adverse health consequences, particularly among older adults, the uninsured, and those with lower incomes.
2. Beyond Healthcare Interactions:
• Transportation isn’t limited to healthcare visits. It profoundly affects other aspects of life and SDOH:
-Employment and Income: Poor transportation access can hinder job opportunities and income stability.
-Essentials and Goods: reliable transportation is essential for accessing nutritious groceries and other essentials.
-Social Engagement: Lack of transportation isolates individuals, impacting mental health and overall well-being.
Adequate and dependable transportation services are fundamental to creating healthy communities.
Casa Companion Transport Solutions: Driving Community Health
As a local service provider in San Diego County, I deeply care about our community. Recognizing the impact of transportation on access to jobs, education, healthy food, social connections, faith-based institutions, and healthcare, I expanded my existing in-home care business to extend our reach further and serve more people in our community. In 2023, we proudly launched Casa Companion Transport Solutions—a specialized division of Casa
Companion Homecare Solutions committed to inclusive and safe non-emergency medical transportation (NEMT).
The Gap We Addressed:
• While our home care services allow caregivers to drive clients in their own vehicles to grocery stores and medical appointments, we realized that a critical segment of our community was being left out: those with mobility limitations.
• Clients who rely on wheelchairs and other mobility devices face barriers to accessing essential services due to the specialized vehicles required for this type of transport.
• We were determined to bridge this gap and ensure that everyone, regardless of physical ability, could maintain their health and well-being.
Introducing Casa Companion Transport Solutions
Our fleet includes vehicles equipped with wheelchair ramps and tailored features for passengers with unique needs. While we continue to serve ambulatory passengers, our true strength lies in serving those with medical and physical requirements.
At Casa Companion Transport Solutions, we drive health using a patient-centric approach:
• Wheelchair accessibility: Equipped vehicles accommodate those in wheelchairs during transport, prioritizing safety and comfort.
• Door-through-door service: Drivers assist clients from their doorstep to the destination, ensuring a seamless experience.
• Timeliness and reliability: NEMT prioritizes medical appointments and well-being.
• Community Connection: We go beyond just getting from point A to B. We’re about fostering connections, reducing isolation, and enhancing well-being.
We understand that transportation isn’t merely about moving people but empowering lives. Whether it’s a medical appointment, a social outing, or a pharmacy run, we make it accessible for all.
Non-Emergency Medical Transport (NEMT) vs. Ride Sharing: Ensuring Safety and Compliance
Not all transportation providers are the same. Safety and reliability are paramount in transportation, especially for medical purposes. NEMT stands out as a safer choice compared to ride-sharing services like Uber or Lyft:
1.Regulation and Accreditation:
• NEMT is heavily regulated. San Diego requires approval from various local government agencies such as the Metropolitan Transport System (MTS), the San Diego County Sheriff’s Department, and the County of San Diego Medical Service Office (Ambulance Ordinance).
• These agencies oversee NEMT providers, ensuring compliance with rigorous standards. Each agency issues its own operation permit or license, emphasizing safety and accountability.
• Riders should be wary of operators who do not have an MTS medallion affixed to their vehicle, as they may be operating without a NEMT permit.
2. Driver Qualifications and Training:
• NEMT drivers undergo thorough background checks via Live Scan fingerprints conducted by the San Diego Sheriff’s Department.
• Drivers complete a paratransit driver application and receive a Sheriff’s Licensed Driver ID card annually.
• First Aid, CPR, and specialized training (such as wheelchair securement and lift ramp training) are mandatory.
• The County of San Diego approves the company’s comprehensive training and orientation program.
3. Drug and Alcohol Testing:
• NEMT drivers undergo regular substance abuse and alcohol testing, ensuring sobriety and safety.
• Random company testing further enhances accountability.
4. Vehicle Safety and Maintenance:
• NEMT providers adhere to strict vehicle requirements:
-Proof of vehicle registration ensures legality.
-Liability, workers’ compensation, and auto insurance are required, and Casa Companion exceeds the minimum requirements.
-Annual vehicle inspections by MTS Inspectors verify safety.
-Certified mechanics conduct pre-inspections annually.
-The County of San Diego approves the company’s Preventative Maintenance Vehicle program.
In contrast, ride-sharing services are not regulated and do not adhere to safety standards offered by quality NEMT providers. While Uber and Lyft serve general passengers, they lack specialized training and equipment for medical transport. Instead, NEMT solely focuses on the well-being of those with mobility limitations, ensuring that health, safety, and quality of life remain uncompromised.
At Casa Companion Transport Solutions, we’re committed to being a community driver of health. Our NEMT services provide peace of mind, knowing that safety, compliance, and patient care are our top priorities.
In contrast, ride-sharing services are not regulated and do not adhere to safety standards...
Christine Lee, a Certified Senior Advisor (CSA), is the Founder and CEO of Casa Companion Homecare Solutions. Recognized among the Best of Home Care ® in the industry, Casa Companion stands tall as an award-winning agency, ranked among the top 10% of home care providers in the United States based on client and caregiver ratings. Christine’s leadership extends beyond home care. She spearheads the expansion of Casa Companion Transport Solutions, offering safe and reliable wheelchair transport throughout San Diego and southern California. christine@ casacompanionhomecare.com www.casacompanionhomecare. com (858) 221-4885
A New Bandage on an Old Problem
Chronic wounds pose significant challenges for many individuals, particularly those managing conditions like diabetes. Wounds are categorized into four stages, with stage four being the most severe. Living with stage 3 or 4 wounds is challenging. Needing to move to assisted living, memory care, or residential care with a stage 3 or 4 wound is prohibited unless on hospice care. However, many individuals in this situation aren’t ready for hospice yet. So then, what to do?
I spoke with Adam Hancock, the Founder and President of www.gotwounds.org, to learn about an effective wound care method for individuals with stubborn, non-healing wounds.
Jacqui: What is the Got Wound’s program?
Adam: The Got Wound program is specifically tailored to help people on Medicare get approved for treatment for advanced wounds that have persisted for over 30 days. Focusing on healing stubborn wounds, sores, and ulcers, our approved products boast an impressive success rate of over 90%. Healing time usually takes 3-6 weeks, depending on the wound’s depth, blood flow, and other factors like smoking and diabetes. A high A1C makes it more challenging, but steps are taken to get the best healing outcome.
Jacqui: What is the product, and how is it used?
Adam: Our product is an amniotic membrane that acts as a covering for wounds and a protective barrier. It contains regenerative properties and anti-adhesive, anti-inflammatory, and anti-scarring properties. This membrane is mainly used to repair Diabetic Foot Ulcers (DFU), Venous Leg Ulcers (VLU), and Pressure Ulcers. It can also be applied directly after Mohs surgery (skin cancer removal).
Jacqui: Wow, sounds complicated. What does it look like?
Adam: It›s straightforward. It’s thin, like a Listerine breath strip you put on your tongue. It comes in multiple sizes, and no suturing is required. It’s easy to use. Think of it as a Band-Aid application without the sticky part. It just lays on top of the wound and does its work. After application, it must be kept dry and attached for the necessary time. Good blood flow helps the healing process.
Jacqui: Where do amniotic membranes come from?
Adam: Amniotic membranes are recovered from
the placenta of healthy, pre-screened donors after a Cesarean delivery, which is performed for other medical reasons. The amniotic epithelial membrane, the intermediate layer of the placenta, is then processed to preserve its structural integrity. This ensures that the product is safe and effective for wound repair.
Jacqui: What about skin tears? We see a lot of tears. Does it work on skin tears?
Adam: If a skin tear hasn’t healed after 30 days of standard treatment, then an amniotic graft can be used on skin tears.
Jacqui: Who applies the amniotic grafts?
Adam: Most wound doctors and podiatrists are familiar with amniotic products and can be trained to administer this treatment. If your doctor opts out, Got Wounds can connect you with a trained doctor, wound care center, or mobile service that comes directly to your home or assisted living community. Got Wounds and its partners train doctors interested in using amniotic products. We prioritize continuity of care and work with patients› current doctors to ensure access to treatment. However, even if a patient’s doctor is unavailable, we find solutions regardless of their doctor’s availability.
Jacqui: What makes this unique?
Adam: Many wound products exist, but Got Wounds has done extensive market research on amniotic membranes. We work directly with several manufacturers and have trusted distributor partnerships. We do our due diligence to secure the highest-quality products that work. We are always looking for the best solutions. Surprisingly, the first amniotic membrane application “was done in 1910 for skin and later for eyes and other surgeries. However, Medicare only started paying for this relatively recently. After multiple studies showed it works, Medicare has approved many more amniotic options for eyes and other specialties.
Jacqui: If this product has been around that long, why haven’t I heard of it before?
Adam: Until November 2023, Medicare regulations limited the education of healthcare providers in most states. We can now educate consumers in all 50 states directly. Now, as consumers, you can ask about this product. In the past, it had to do with billing, and your doctor had to request it. It was also a bit taboo because many associated it with
stem cell research, questioning how it was sourced. Although it is not considered a stem cell since it comes from the placenta, it still has some excellent healing qualities. Got Wounds has some of the best billing and coding experts, so now Medicare pays, as long as there is proven medical necessity - hence the 30 days or more of standard wound care. Jacqui: Ahhh! The name of the Medicare game is coding! I get it.
Jacqui: If you’re under 65, does regular health insurance cover it?
Adam: Unfortunately, only Medicare Part B consistently pays for it. Medicare Advantage plans sometimes cover it, and regular commercial insurance has started showing interest in approving amniotic grafts. We will only send the product to your medical providers once Medicare approves it.
Jacqui: Is Got Wounds the only company doing this?
Adam: Other companies are out there, but the biggest issue is access to the right products and
adequate supply. Got Wounds gets its supply directly from multiple trusted manufacturers, which control the cost and quality of the product. This is key. Got Wounds is one of the few companies with specific wording for getting Medicare to approve and cover this procedure. This requires good documentation by the provider and, ultimately, the best outcomes for people dealing with wounds.
Jacqui: Sounds like you love what you do. Adam: I’m passionate about this field and dedicated to supporting patients’ healing journeys while maintaining continuity of care with their current providers.
Jacqui: Well, I am excited about access to this solution. When consumers are involved in managing their healthcare, we see better outcomes. I know my colleagues are excited about the prospects of what this very important “bandage” will do for the industry. Thank you, Adam, for sharing with our readers.
Adam: Thank you, Jacqui!
Adam Hancock is the Founder and President of www. gotwounds.org
Contact Adam Hancock to find a solution to bring you the needed wound care. Adam provides extensive education on the process to help ensure there are no out-of-pocket costs. (707)-5839811 healing@ gotwounds.org
From Emergency Physician to End-of-Life Care
Transitioning from the intensity of the emergency room to the sacred space of end-of-life care has been a profound journey for me. I was an emergency physician for the first 25 years of my medical career, during which time I cared for many people who were dying or were close to dying.
Doctors, especially Emergency Medicine (EM) doctors, are taught to do whatever it takes to save lives. We are not taught to consider whether the quality of life available to that person would be acceptable to them should they survive.
While I provided excellent and compassionate care to many patients, I am painfully aware that empowering them and respecting their dignity as they were dying was not always possible, given my responsibilities as an EM physician.
A pivotal experience in 2001 forever altered my perspective. My friend Darren was diagnosed with Malignant Melanoma at the age of 31. As he became more ill and his death grew nearer, I found myself coordinating a small group of people–his family, close friends, and hospice care team–all committed to respecting his wishes throughout the journey and supporting him in experiencing a peaceful and painless death.
During this time, we co-created beautiful experiences that brought him joy and gave us time to be together to honor him. This was also my first exposure to hospice, and it opened my eyes to the immense value a committed hospice team can provide.
When Darren died on September 14, 2001, three days after 9/11, I began to reevaluate how I viewed and approached death and dying.
Despite continuing as an Emergency Medicine Physician, my focus shifted toward compassionate care for the aging, ailing, and terminally ill. I found a house call practice for homebound seniors. In 2004, I co-founded a non-medical caregiving agency and adult day healthcare center to address the needs of the local elderly community.
After relocating to San Diego, a profound experience in 2013 led me to my true calling: supporting people in having the most peaceful, meaningful, and dignified end-of-life experiences possible.
I transitioned into palliative and hospice care to support patients and their loved ones in this critical time of life. I quickly realized that insurancebased care did not adequately serve many of these patients and their families optimally.
End-of-life care is almost exclusively relegated to hospice agencies, which have constraints and limitations because they are paid for by Medicare, Medicaid, and private insurance.
In 2016, I stepped away from the “system.” I created a medical practice to fill the gaps in healthcare that I had identified over 30 years in medicine. With my wife and business partner, Elizabeth, we refined our model of Aging, Palliative, and end-of-life care, assembling a team of passionate experts in these fields who are equally committed to ensuring optimal support for patients, families, and collaborating providers.
Central to our model is the partnership between doctors and doulas, which ensures patients receive medical expertise and emotional support throughout their journey. This collaborative approach fosters a sense of connection, belonging, and empowerment for patients, families, and providers as we walk together through the intricacies of complex care and end-of-life transitions.
In medical school, you’re taught that death = failure. After 30+ years in medicine, I’ve come to see death as an integral part of life.
Everyone deserves compassionate, dignified care that honors their unique wishes and values. Our mission is to reimagine the final chapters of life, ensuring each person feels heard, held, and whole throughout the journey.
Bob Uslander, MD, and Elizabeth Uslander, MSW MTS, are the co-founders of Empowered Endings, a unique model of Endof-Life Care that fills the glaring gaps in traditional Palliative and Hospice Care and emphasizes wholeperson and family care, including the emotional, intellectual, and spiritual health of patients and their loved ones. They are working on their forthcoming book, Permission to Choose. Visit empoweredendings. com/events to find an event near you.
NAVIGATING THE AGING GAME NAVIGATING THE AGING GAME
Let Aging Well be your guide to navigating the aging game with trusted partners and valuable insights. Can you navigate the maze above? Find your way from left to right then cut out the pieces below for a traditional game of checkers!
You Packrat Tendency May Actually Be ADHD
Idiscovered my own attention deficit hyperactivity disorder (ADHD) when my child was diagnosed in his junior year in high school. As I learned about ADHD, it felt like I’d found my “operating manual.” Things I did that made me feel different than my peers suddenly made sense. It only took eight more years to realize my mother, who I thought had “hoarding disorder,” actually had undiagnosed ADHD.
My mom could be described as a “packrat” with piles of stuff stacked all over her home covering furniture. When I began examining it more closely, I realized how much of my mother’s “things” were actually new and uncompleted projectssomething she’d get excited about at the moment and then move on to the next shiny object. If my mom was “saving” things, it was because she believed there would be some project she could create with it. Unlike the clients we see with hoarding disorder, my mother wasn’t distressed by the idea of discarding items; she was overwhelmed and unsure where to begin to get organized.
People with ADHD struggle with executive functioning and often prefer to avoid boredom - hence the constant start of new projects. Due to our dopamine deficiency, we might shop, drink, binge eat, or engage in other reckless activities.
Until the 1980s, it was believed ADHD was something only boys had and that it would be outgrown; this means many diagnoses (especially among women) were missed, and older
adults in school well before the 1980s were even less likely to have had a diagnosis. ADHD shows up differently in each of us. One of my favorite quotes by Dr. Ned Hallowell is, “Having ADHD is like having a Ferrari brain and bicycle brakes.”
In her book Still Distracted After All These Years, Dr. Kathleen Nadeau writes about help and support that will benefit older adults with ADHD. In our podcast interview, she explained it was difficult to get published because the thought was seniors have lived this long without knowing they have ADHD, so why change anything now?
Grandma Has ADHD podcast explores this topic. Launching July 4th, we’ll uncover strategies for making life easier and hear seniors’ stories about navigating life with ADHD. One of many strategies I’ve learned is to understand the two times the ADHD brain has: “now” and “not now.” Now, I habitually set “Future Jami” up for success. For example, rather than scrambling for what I’ll need to leave the house in the morning, I gather everything together the night before and put it in my car.
About Jami Shapiro: Jami is the founder of Silver Linings Transitions and creator of “Grandma Has ADHD.” She is a Level II ADHD specialist with the Institute for Challenging Disorganization and a Certified Senior Move Manager.
The Silver Linings Transitions team assists seniors in moving by helping sort belongings, packing, unpacking, organizing, and coordinating all the logistics. We also provide home organization services for those challenged with organizing or needing a freshen-up. We create systems for our chronically disorganized clients to help them remain organized with “a scaffolding for success.” To learn more about seniors and ADHD, subscribe to our podcast or visit our website. www. silverliningstransitions.com or 760 522-1624.
The Biggest Mistake in Aging? Waiting Too Long to Move
What is the biggest mistake in managing the aging process?
The answer is easy: People wait too long to get help at home or move to assisted living or memory care.
Older adults often delay moving to assisted living or planning for home care. They recognize the need for more care but hesitate due to the difficulty of leaving a familiar life, fear of losing independence, believing they have more time, thinking it’s unaffordable, or denying their care needs. However, delaying this decision can lead to a significant financial burden. The cost of care after a medical emergency is much higher than a well-planned move to assisted living or memory care.
Here’s a common scenario: “Tom” has Parkinson’s and falls, while “Cathy” has severe mobility issues and falls often. Although they have no cognitive decline, their extreme fall risk is critical. Falls are the top reason for sudden moves to assisted living. Each fall worsens mobility and increases care costs. Had they moved to assisted living earlier, their care costs would have been significantly lower, and their independence would have lasted longer.
Independence is essential to aging adults, and mobility is critical to maintaining independence and reducing care costs. Many believe they have
more time before needing help and delay hiring caregivers or moving to assisted living. However, delaying these decisions is only a temporary fix. Fear of the unknown also contributes to this delay.
Fear of the Unknown
Many fear assisted living and memory care because they don’t understand what these communities offer. A consultation with a local senior care professional can alleviate these fears. These professionals visit the communities and can provide detailed information about the care services and amenities available.
A realtor, a well-meaning caregiver, a concerned neighbor, or a professional in another field (i.e., financial advisor) is not someone you should consult when you want to learn about assisted living and memory care. Use a Certified Senior Advisor™, even better if they are a Certified Placement & Referral Specialist (CPRS) through the National Placement & Referral Alliance (NPRA). Keep this in mind when well-meaning people offer advice on aging in place or moving to assisted living and memory care. We use consultants and pay for expertise in many areas of our lives. Your aging needs deserve a professional as well. A consultation will cost you nothing, but it’s guaranteed to give you the tools to design the aging journey you want and give you the peace of mind you need.
The cost of care after a medical emergency is much higher than a wellplanned move to assisted living or memory care.
Jacqui Clark is a Certified Senior Advisor™ (CSA™), Certified Placement & Referral Specialist (CPRS), Senior Care Consultant, and Founder of Living Coastal Senior Resources. She is an industryleading living-andaging well expert and a respected communications specialist. She is the Editor of Aging Well Magazine. She has been blissfully working with aging adults for over a decade. Jacqui@ LivingCoastalSR.com www.ThisIs LivingWell.com
The Power of Music
For the past eighteen years, from 2005 to 2023, I’ve spent most of my time working at what has always mattered to me: helping families keep their loved ones safe and independent. I founded and owned a home healthcare company in North San Diego County. But my biggest passion has always been music – listening, playing, singing, performing. Even though I never had as much time as I wanted to spend on it, somehow, I always found a way to make it a big part of my life and even integrate it into my work.
In the early days of my home health company, I would provide musical entertainment at the annual national conference of our franchising company and sometimes put together sound recordings or perform in skits that played into the theme of each meeting. One year, the conference theme was Back To The Future. To open the event, I dutifully dressed up like Marty McFly from the movie, stood behind a wall of cardboard boxes onstage with my guitar and a headset mic, and burst forward after a short clip from the film to perform the Huey Lewis and The News songThe Power of Love, to a cheering, clapping audience of fellow home health care agency owners.
It wasn’t the first time I’d witnessed the power of music to evoke deep emotion, positive excitement, and joy in a relatively diverse group of people. Music is something we all grow up with and grow old with. It truly is the soundtrack of our lives, and mainly, the songs that were popular as we grew up are touchstones that mark essential periods in our lives. They never fail to evoke vivid memories of what we were doing or what was happening when we heard a particular song playing.
So it was no surprise that years before the groundbreaking 2014 Glen Campbell documentary I’ll Be Me, our company began to understand the value of music in connecting with older adults and clients suffering from dementia. The Company started a music therapy singalong program provided to senior communities and one-to-one with clients in their homes. I soon found myself leading these singalongs for seniors throughout North County. On occasion, I’d visit a client on their birthday to play them their favorite song on the guitar. Besides helping someone stay independent in their own home, music was my favorite part of running my agency.
It’s well documented that listening to or making music increases blood flow to the brain’s regions that generate and control emotions. As you enjoy a particular song for the first time or hear it again, your body may release dopamine, a neurotransmitter that triggers sensations of pleasure and well-being. Just as we can often quickly identify the emotion conveyed by a particular song, music can easily affect our emotions.
There are also extraordinary benefits to learning and/or playing an instrument as we age or simply singing along to favorite songs. From personal experience, I can say that I always feel uplifted after these activities, and I love to teach the ukulele, an easy-to-learn, easyto-play instrument, to older adults.
The Glen Campbell documentary underscores the positive effects of music from a performer’s perspective. Despite his advancing struggles with Alzheimer’s, he was generally able to recall the words and instrumentation of each song in his performances. According to an article in the Journal of Biology, decoding music is a big task for the brain, requiring the integration of “sequentially ordered sounds into a coherent musical perception.”
These days, I’m retired from home health care, and keeping my mind fit and active is hugely important. Since my retirement, I have focused on my other lifelong profession and passion: performing music. When I perform for any audience, it’s a mutually beneficial proposition. They get joy from the performance, and I get joy from it. We both get the related positive benefits to our health.
Nowhere are these benefits more evident than when I play and sing for an audience in a memory care unit. It’s difficult to describe the positive feeling that washes over me when I see a dementia patient suddenly change expression from a blank stare to a pleasant smile, then close their eyes and begin mouthing the words to the song I am singing to them. At one of my recent performances, I played Mrs. Brown You’ve Got A Lovely Daughter, an old Herman’s Hermits song and was surprised to see how many in the Memory Care audience remembered every word.
Music is a powerful connector with people and an incredibly positive memory trigger… it’s my sincere belief that everyone should have some music in their life, even more so as we age.
Nowhere are these benefits more evident than when I play and sing for an audience in a memory care unit.
Samuels is a singer, songwriter, and performing musician. He is an 18-year veteran of the home healthcare industry in North County, San Diego. He performs at theatres, clubs, and senior communities around San Diego with Solitary Diamonds, a tribute to Neil Diamond, and several other musical projects. Hear Scott play on July 27th; when he performs as Neil Diamond at the Oceanside Brooks Theatre. www. oceansidetheatre.org/ tickets
Scott
Getting Long-Term Care Insurance to Pay
By Jacqui Clark, CSA
Thirty-seven years ago, in 1987, Linda Jahnke started a successful business selling Long-Term Care (LTC) policies. She diligently read every policy cover to cover to understand what she was selling to her clients. She sold every available insurance product and became well-versed in LTC contracts. Usually, that would be the end of the story, but it wasn’t.
In 2010, twenty-one years later, Linda saw a client, “Marlene”, at an event and noticed she looked unsettled. Marlene, a former teacher who was always impeccably dressed, appeared disheveled that day. Concerned, Linda visited Marlene at her home and discovered she was in bad shape. Marlene had a caregiver who was only a few years younger and also struggling
with aging issues.
Marlene suffered from chronic, debilitating pain, and Linda quickly realized she needed help. Linda tried to arrange a better caregiving situation and additional support, but Marlene refused. Respecting their professional relationship, Linda didn’t push further.
However, Linda did offer to start Marlene’s LTC claim, which Marlene accepted. Linda filed the necessary claim, expecting the policy to be activated so Marlene could receive the benefits for which she had paid premiums for decades.
Four months later, Marlene fell at home, worsening her pain. Despite this, she still had not received approval for the pain medication pump she desperately needed. Marlene told her
caregiver it didn’t matter because her LTC had also been denied. That night, Marlene took her own life.
Linda can’t say for certain if the claim denial was the last straw for Marlene, but it left her feeling shocked and guilt-ridden despite her efforts to help. She was also frustrated with the insurance company, as there was no reason the claim should have been denied. Linda knew she had sold Marlene a good policy.
Linda called the insurance company and learned the claim stalled because Marlene missed multiple calls to schedule a required interview, and her caregiver failed to submit additional forms. It was a series of “mix-ups”, but was this an isolated incident or a common problem?
Marlene had responsibly purchased the policy, but the insurance company let her down, and she failed to ask for help. Linda realized she needed to assist her clients in activating their policies, as insurance companies were not looking out for them.
Over the next two years, Linda helped clients activate their LTC policies, but she was stunned by the constant obstacles and resistance from insurance companies, who seemed determined to avoid paying out claims. Linda’s client list grew rapidly, revealing a significant need for her services. She decided to become an advocate. As a Board-Certified Patient Advocate, Linda was able to create a thorough process for filing claims.
Jahnke Consulting, specializes in navigating and managing long-term care insurance claims. Their proprietary claim protocol has resulted in a 99.9% success rate in claim approval and accurate benefit payments. This unique process relieves clients of time-consuming phone calls, cumbersome oversight, and miscommunication. Families can focus on what they do best; offer comfort, companionship, and care. Not only do Linda and her team file claims, but they also assist in referring vetted care providers. LTCi claims are organic ongoing events, the team at Jahnke Consulting supports the insured at every step in the process.
Today, no one offers the same service which Linda Jahnke has created. She is unparalleled in her field. While some insurance brokers help clients file claims, their five-step process ensures success. This oversight prevents minute details or requirements from slipping through the cracks which inevitably creates payment delays. Giving insurance companies no grounds to deny claims. Linda can work in all 50 states.
Some insurance carriers, actuaries and Third-Party Administrators may not appreciate Linda’s pioneering advocacy. Her record disrupts their calculations and pricing strategies (actuaries). However, to the 7.1 million policyholders, she provides peace of mind, ensuring their purchased insurance will be there when needed. Isn’t that the purpose of buying insurance in America?
Initially facing resistance, Jahnke Consulting has established a lasting presence, fostering a working relationship with reputable insurance carriers. Linda takes pride in her work and emphasizes the importance of ensuring fairness by leveling the playing field.
Here are the Five Pillars that are the foundation of Linda’s model:
1. Claim Vetting and Contract Review: Linda reads all contracts thoroughly. She advises an insured if they could be eligible and if their care providers would be
approved as paid caregivers.
2. Medical Records: A case manager adeptly obtains necessary medical records, a common reason for claim closures. This is not an easy task.
3. Billing: The billing department sends invoices and care logs to carriers to ensure clients are paid promptly.
4. Accounting: The accounting team reviews statements to confirm accurate policy payouts, correcting frequent mistakes.
5. Nurse Advocacy: An RN attends required assessments, using the correct terminology to safeguard policies are activated and paid.
TIPS:
1. Don’t Rely on Insurance Companies: They often make it difficult to activate your policy and can delay or deny claims. Most carriers are not selling products anymore, so they have no skin in the game to get positive reviews or provide good service. These policies were bought 20-30 years ago.
2. Act Quickly: Many policyholders wait too long to use their benefits. This is a mistake.
3. Beware of TPAs: Third-party administrators (sometimes called care coordinators) work for insurance companies and may not prioritize your needs. They profit more when your policy pays out less or nothing at all.
4. Complex Contracts: Understanding your contract is crucial. Jahnke Consulting’s expertise shines through, drawing on years of experience.
5. Expert Support: Jahnke Consulting collaborates with senior industry experts to ensure proper management of your policy benefits.
6. Cost: The first year involves a retainer. While the second year is optional, it’s recommended for ongoing support for required recertification and additional claim filings that can pop up.
7. Mindset Shift: Treat your policy as a contract that requires understanding and education to obtain the benefits you bought.
8. Life-Changing Advantage: LTC policies provide significant support, allowing you a better chance to age in place, move to the care community of your choice, and offer relief to family caregivers.
9. Linda’s Advice: Your 50s are the golden decade to buy an LTC policy. Aim for a solid monthly benefit of $5K (or higher) and a minimum 2% inflation rider.
*Thank you to Linda Jahnke for discussing Long Term Care with me.
Linda Jahnke, a Board-Certified Patient Advocate (BCPA), is the founder and CEO of Jahnke Consulting Inc. With over 35 years of experience in the long-term care insurance industry, she specializes in interpreting longterm care policy language and advocating for clients to ensure their claims are paid. www.
jahnkeconsultinginc.com (858) 513-8351
Writing Your Way Back to Yourself After Loss
During the Covid pandemic, I turned fifty, the youngest of my three kids got their driver’s license, and I lost my mom. Suddenly, I was no one’s daughter. I felt like an adult orphan. While friends celebrated their parents’ golden anniversaries and 80th birthdays, I lit remembrance candles and celebrated Mother’s Day without my mother. I went from driving my kids to soccer practice, taking my mom to doctor’s appointments, and getting her nails done to having a tornado of time and no idea what to do with it.
Identity is a funny thing. We wrap it around ourselves and live inside it—whether that identity is husband or wife or mother or daughter, our roles define who we are. Everything shifted when I lost my roles as an active mother and dutiful daughter. I felt adrift with no tether to who I was. It was scary, drifting along the waves without an anchor, not knowing where I was going or when I would get there, if ever.
These changes left me grieving my old life, and that grief needed an outlet. Writing was a way to connect to my losses, feel my feelings, and eventually allow myself to dream about the next phase of life. Writing was not always easy, but it was always healing.
Many people yearn to write but find developing a regular writing practice challenging or scary, or they need help knowing where to start. Here are a few steps to begin writing as part of the process of healing and reinvention:
Tip 1: Revise Your Limiting Beliefs
Studies show that expressive writing improves mental and physical well-being, but too often, people approach the blank page with fear. If, somewhere along your journey, you were told that you were not a “real writer, “that you were not a “good writer,” or that you were “not creative,” these beliefs can keep you from fully expressing yourself.
Before you launch a regular writing practice, consider what you believe about writing, yourself as a writer, and the value of your voice. It is hard to write if a sneaky voice inside you tells you that you are not a good writer, don’t have what it takes to write, or don’t have anything of value to share.
If you find limiting beliefs operating inside of you, let them go and create new, encouraging beliefs that support your desire to express yourself, such as I am open to discovering my voice, I am worthy of writing, and I am a creative person by my very nature.
Tip 2: Write to a Timer Sometimes, people feel called to write but fear the empty page.
The idea that “I don’t know what to write about” can cause paralysis. But the truth is, you do not need to “know” what to write about. “Don’t think. Just write.” is my motto because I believe our truest self-expression does not come from our minds but rather from our hearts, souls, and bodies. Set a five-minute timer and write the entire time without stopping, editing, or thinking. This stream-of-consciousness writing helps unleash the words that want to emerge and allows you to connect more deeply with your most authentic self.
Tip 3: Don’t Let the Small be the Enemy of the Done
When developing a writing practice, start small. Commit to writing twice a week for ten minutes and build from there. Too often, people think they must set aside hours to write or write daily, and if they cannot keep it up, they give up. This is not true. Begin regular writing practice by making small, easy commitments to write and growing your writing practice from there.
Whether you write a few times a week in short bursts or for more extended periods, allowing yourself to write freely and regularly will help you reconnect to yourself, process your emotions, and discover your hopes for the next stage of life.
Robin Finn, MPH, MA, is an award-winning writer and author of Heart. Soul. Pen: Finding Your Voice on the Page and In Your Life Her work appears in national and international press. She teaches at UCLA, holds master’s degrees from Columbia and the University of Santa Monica, and writes on midlife, spirituality, and creativity. Visit www.robinfinn.com.
Five-Minute Guacamole Recipe
Summertime San Diego Guacamole Recipe
This quick and easy guacamole recipe captures the essence of summer and the vibrant flavors of San Diego. Perfect for any gathering, this guacamole pairs wonderfully with your favorite salsa and is ready in just five minutes.
Ingredients:
• 4 ripe Hass avocados
• Red onion, diced (to taste)
• Garlic salt (to taste)
• Garlic powder or finely minced fresh garlic (to taste) Juice of half a lime (to taste)
Instructions:
1. Prepare the Avocados:
• Cut the avocados in half, remove the pits, and scoop the flesh into a medium bowl.
• Mash the avocados with a fork or potato masher until chunky. Avoid overmixing to keep some nice avocado chunks in the guacamole.
2. Add the Onion:
• Dice the red onion finely and add it to the mashed avocados. Adjust the amount based on your taste preference.
3. Season with Garlic Salt:
• Start with a small amount of garlic salt. Sprinkle it over the mixture and mix gently. Taste and adjust if necessary. Use garlic powder or finely minced fresh garlic for a stronger garlic flavor without extra salt.
4. Add Fresh Garlic (Optional):
• If you prefer a more pronounced garlic taste, sprinkle in some finely minced fresh garlic. Mix gently to incorporate.
5. Lime Juice:
• Squeeze the juice of half a lime over the mixture. Stir gently and taste. Add more lime juice if desired, but start slowly to avoid overpowering the other flavors.
6. Finish:
• Give the guacamole a final mix, depending on your preferred consistency. You can make it smoother or leave it chunky.
7. Serve:
• Serve immediately with your favorite tortilla chips, alongside salsa, or as a topping for tacos, nachos, or any of your favorite dishes.
Enjoy your Summertime San Diego Guacamole!
RESOURCE GUIDE
Melina Rissone, REALTOR® (619) 865-6017 melina@melinarissone.com www.melinarissone.com
As a SRES Associated Real Estate Broker with Coldwell Banker West, Melina Rissone’s mission is to support active adults and seniors with their real estate planning. She understands the emotional demands and can help minimize them. She takes the no-pressure approach to the transaction and is 100% service oriented..
Patti Gerke, REALTOR® (760) 525-7269 patti@pattigerke.com www.agingwellpartners.com/partners/pattigerke-realtor/
Patti Gerke is a Senior Real Estate Specialist® (SRES®) and a Certified Residential Specialist® (CRS®). Whether downsizing, distributing estate assets or moving across the country, Patti’s #1 mission is to provide each client compassionate perseverance to provide resources, expertise and guidance through the real estate planning and selling journey.
Joseph M. Casciani, PhD (858) 272-3992 jc@livingto100.club www.livingto100.club
Dr. Joe Casciani is the Chief Curator for the Living to 100 Club, a source of solutions to living longer and healthier: with a special focus on mindset, outlook, and positive attitudes about aging. He offers individual coaching sessions for seniors and their families to help cope with aging.
Bob Heck & Joan Chintz, Broker Associates (310) 251-7158 Rtheck007@gmail.com www.agingwellpartners.com/partners/ chintz-team-real-estate-professionals/ Joan Chintz, Certified Probate & Trust Specialist has the experience in real estate that gives you peace of mind. Bob Heck has been a Senior Transitioning Specialist for over a decade. They understand transitioning into your next chapter in life and they’ve got you covered. Local Expertise. Global Connections.
Sean Kuhn (619) 391-8688
info@kuhnphysicaltherapy.com www.physio-on-the-go.com/ Physio on the Go is here to provide clients with a unique, highly individualized, and convenient model of care, that brings selfcare, wellness, and physical therapy directly to you—online or at home. Our mission is to empower clients to improve their health and enhance their longevity.
Daniel Sweiger, Owner (760) 448-1021
Dan.Sweiger@brightstarcare.com www.brightstarcare.com/carlsbad
A family-owned & operated company providing award-winning home care services. We help seniors and others with medical challenges remain home longer -- safely and comfortably. Our full range of services includes companion care, personal care, skilled nursing, and specialized support for those living with Alzheimer’s, dementia, and Parkinson’s.
Jennie MacGoy Yoga (703) 579-0123
jennie@jenniemacgoyyoga.com www.jenniemacgoyyoga.com
Specializing in providing gentle yoga and movement to people living with persistent and chronic pain, who are new to yoga, or don’t think yoga is for them. Visits to your home, park, or beach utilizing the extensive study of anatomy, strengthening, and restorative rest as it relates to yoga.
George G. Glenner Alzheimer’s Family Center (619) 543-4704 information@glenner.org www.glenner.org
The George G. Glenner Alzheimer’s Family Centers, Inc.® provide specialized day programs for seniors with Alzheimer’s and other forms of dementia. Care is available Monday through Friday with full-day and half-day rates available. Each center offers structured, therapeutic activities and socialization in a safe, secure, family-like environment.
St. Paul’s PACE (619) 677-3800 info@stpaulspace.org www.stpaulspace.org
St. Paul’s Program of All-Inclusive Care for the Elderly (PACE) is a managed health care plan exclusively for seniors. As part of St. Paul’s PACE, you receive primary medical care, medication management, physical therapy, specialty services, in-home care, social work assistance, and transportation to and from the medical center.
Bryan Devore (760) 908-3838
Bryan@DevoreRealtyGroup.com www.devorerealtygroup.com
The Devore Realty Group provides three home selling optionstraditional home sale, renovate-to-sell, and as-is sale. Included in each home sale option are FREE downsizing services, and if you are considering a move into a senior community, we can help defer your move-in costs until after your home sells.
San Diego Oasis (619) 881-6262
info@sandiegooasis.org
www.san-diego.oasisnet.org
Oasis is a unique educational program for adults 50+ who want to continue to learn and be productive throughout life. Membership is free and open to anyone 50 or older. Join Oasis and enjoy stimulating classes and opportunities to serve your community.
Julie Derry (619) 378-6895
julie@aging123.com www.aging123.com
At Aging123, we specialize in educating, advocating and navigating the placement journey for aging adults and their loved ones. We’ve toured and inspected all Assisted Living and Memory Care homes and communities we refer our clients to; all you have to do is make the choice that’s right for YOU.
Silver Linings Transitions (760) 522-1624
info@silverliningstransitions.com www.silverliningstransitions.com
Senior Move Managers, we assist adults and their families with the emotional and logistical aspects of relocation– whether it’s to a smaller space, moving to be near family, or moving into a senior living residence. Let Silver Linings Transitions take the worry (and work!) out of the moving process.
Jacqui Clark (760) 218-9866
Jacqui@LivingCoastalSR.com
www.agingwellpartners.com/partners/ living-coastal-senior-resources/ Living Coastal Senior Resources have the knowledge and experience to solve the many challenges that can come with aging. We consult, advocate, and oversee the entire process of aging in place at home, managing disease, or finding the right assisted living or memory care. Age well with the right choices.
Jacqueline Silverman (858) 395-7733
jacqueline@agingadvisoryservices.com www.agingadvisoryservices.com
Aging Advisory Services promotes aging in place by helping older adults in the San Diego Region better understand, plan for, and manage changes associated with aging. We offer home safety assessments, referrals, and consultation services to enable people to live safely and comfortably in the residence of their choice.
Nona’s Home Care (619) 788-4459
info@nonashomecare.com www.nonashomecare.com
At Nona’s Home Care, our caregivers have been thoroughly trained and practiced in providing the best home care assistance while catering to the specific needs of each client. We bring the highest quality care to you, so that you may thrive in your most comfortable, and familiar environment.
Holli Bennett (619) 832-6963
holli@coastcare.org www.coastcarepartners.com
We are a compassionate, non-medical home care agency servicing San Diego County. Our trained caregivers provide personalized assistance, promoting independence and enhancing quality of life empowering exceptional care and peace of mind for families.
Harmony Home Medical (858) 560-8177
erica@harmonyhomemedical.com www.harmonyhomemedical.com
Harmony Home Medical Supply is a medical equipment and home accessibility retailer that has been serving San Diego County for the last 15 years. They provide the products and services that can help someone live more independently and safely wherever they call home. They are truly a one-stop-shop for Aging-In-Place.
Melanie L Delgado; Owner (619) 937-2330
wecare@homecare-sd.com www.homecare-sd.com
Right at Home provides quality in home care services in San Diego. Our caregivers are trained, bonded and insured to provide a wide range of services and specialized support for Alzheimer’s, dementia and Parkinson’s. An authorized agency for the VA we provide exceptional care to our area veterans as well.
Now Haus ADU, LLC
Bill Adamas (619) 537-0066
Hello@Now-Haus.com www.NOW-HAUS.com
Now Haus ADU, LLC. is a residential real estate development company specializing in ADU’s (Accessory Dwelling Unit) and Lot Splits. The new law SB9 allows innovative options for seniors to age in place and increase their retirement nest egg. We offer free property analysis and onsite consultations with homeowners looking to maximize their property’s potential.
Rehburg Life Insurance Settlements
Lisa Rehburg (714) 349-7981
Lrehburg@aol.com www.rehburglifesettlements.com
We are life settlement brokers, helping clients sell their life insurance policies for cash. This cash can be used for anything, including saving for retirement, debt repayment, and long-term care. Our fiduciary duty is to our client to market their policy to obtain the highest amount of money that we can.
Unveiling the Tapestry of Your Family Heritage Argentina
Argentina Holds the Mystery
I never knew, until my grandfather, Vicent Armando Cecchini, passed away, that he was born in Bell Ville, Argentina, not Italy, as we believed. In the late 1800s, work was sparse in Italy, and Argentina was booming and needed laborers. The British built a rail system, and Argentina built the “Houses of Immigration” for the workers to live in while establishing themselves and their families. I was able to piece it together by visiting Bell Ville, Argentina, where my great-grandfather (Vicente’s father) lived in the “House of Immigration” while working as a Terrazzo layer. Visiting the “House of Immigration” was an incredibly moving and emotional experience. Visualizing my great-grandfather’s life provided a tangible link to his sacrifices to build a new life.
We toured the City and went to the municipality to see if we could find any marriage or death certificates for my great-grandparents, but nothing was found. Since no marriage certificate was found in Argentina, it’s assumed my great-grandfather returned to Italy to marry my great-grandmother and brought her back to Argentina, where they started their family. They had five children in Argentina; one passed away after birth. My grandfather, Vincent, was the
youngest of the four remaining children.
Next, we visited the Church of the Immaculate Conception, which was fascinating. I found the handwritten books documenting my grandfather’s baptism and the names of his godparents with the events’ dates. Seeing their actual signatures made it real.
Vicente Armando Cecchini was born on March 23, 1902, and baptized in May 1902. The fragile cabinet storing the books barely stood, and the bindings were threadbare. The smell of the old books evoked a sense of nostalgia and connection to the history preserved over the years. This document confirmed Vicente’s birthplace was Argentina. Mystery solved!
With the assistance of a local college professor, we were granted access to the “House of Immigration.” It was surreal to see the train tracks outside the building (no longer in use), the big pots used for cooking, baby cradles, suitcases, etc., all from another time in history.
The family eventually returned to Italy. In the early 1900s, my grandfather and his three siblings immigrated to the USA via Elis Island. Interestingly, 48% of Argentina’s population today are of Italian descent.
(TOP): The Church of The Immaculate Conception, where my grandfather was baptized and the baptismal font; The House of Immigration in Bell Ville.
The cabinet and books with the actual documentation of my grandfather’s baptism.
Sicily
Italy: A Fish Monger, A Farmer, and A Neighbor
We adjusted our compass for Italy to see what exciting history we could dig up on my husband’s maternal grandfather. We knew he was born in Sicily and, on our trip, confirmed it was in Termini Imerese, a small fishing and farming village between Palermo and Cefalu on the island’s northwest side.
In the late 1800s, in Termini Imerese, children were born at home, and the parents and “witnesses” brought the baby to the City’s municipal building to document their birth. We found the book at the municipal building, which recorded that Salvatore Malatia was born on April 22, 1896, at 11 PM. Such detailed records! His witnesses were a fish mongrel, a farmer, and most likely their neighbors and/or friends. (Photo 11,12,13)
We found the address of the home where he was born – 9 Via Grifo. We traveled steep, narrow streets to the family’s home on Via Grifo. Immediately, the neighbor across the street came out to see what we were doing in the neighborhood since we didn’t look like we belonged. After a bit of conversation, she conveyed no recollection of anyone by the surname Malatia who had lived there. So, we had no luck finding any current relatives in the area to connect to.
We visited the neighborhood Church, St. James, where he was most likely baptized, but we could not connect with anyone at the Church to confirm his baptism. Salvatore immigrated to the United States with his family via Ellis Island in 1901 at 5.
Both trips made us wish we had asked many more questions about our heritage when our parents and grandparents lived.
Passing on family heritage is a way to preserve and honor the traditions, values, and experiences that have shaped our identities and enriched our lives. It allows us to connect with our roots and ensure that the stories and wisdom of our ancestors are not lost with time for future generations to enjoy. It’s a way to create a lasting legacy and foster a deeper appreciation for our roots and our family’s history.
Spend time with your loved ones, pass down what you know, and don’t wait to ask questions. You don’t want to miss the opportunity to preserve and honor your lineage.
**There are many ways to document your loved ones, from video recordings to Storyworth.com or LifeArk.io. To dig deep into your heritage, visit AccessGenealogy.com, FamilySearch. org, USNationalArchives.com, or Worldgenweb.org. You can also contact local travel companies in your family’s birth city.
Patti Gerke is a Senior Real Estate Specialist® (SRES®), a Certified Senior Advisor® (CSA®), and a Certified Aging in Place Specialist® (CAPS®). For the past 23+ years, she has specialized in working with seniors and their family members, utilizing her compassionate perseverance to provide guidance, assistance, and expertise when wanting to Age in Place with dignity and independence… or selling their home. She’s lived in Carlsbad for 40 years with her husband. Find Patti at patti@pattigerke.com
Via Grifo where Grandfather lived until he was 5 yrs. old, before immigrating to the US.
St. James Church, just down the street from the house and most likely where he was baptized.
Professional Fiduciaries: What They Are and Why They Are Important
ONE MORE ESSENTIAL TOOL IN OUR AGING BOX
By Jacqui Clark, CSA, Editor of Aging Well Magazine
With a record number of Boomers approaching 65 in 2024, it’s crucial to highlight the unique benefits of professional fiduciaries. This generation, our wealthiest yet, places a high priority on financial planning and management. A professional fiduciary can offer additional advantages even if you’ve already done estate planning. For instance, if you have heirs who don’t get along, don’t align with your aging plan, or choose not to rely on them, a professional fiduciary can act as a neutral party. They can manage your assets and affairs to align with your wishes, minimizing potential conflicts among your heirs while you are alive and after you have passed. Essentially, they become an extension of you, ensuring your financial and personal affairs are managed according to your wishes.
A professional fiduciary (PF) plays a valuable role in managing your personal and financial affairs when you cannot do so or choose not to. They are adept at handling various tasks, from bill paying and investment management to making healthcare decisions if desired or necessary. Some PFs specialize in personal care, while others focus on financial management. A PF can also handle both aspects. Unlike lawyers who provide advice, PFs make decisions based on the authority you grant them. In California, where PFs must be licensed, they can serve as conservators, medical decision-makers under a DPOA (Durable Power of Attorney), and financial managers. The key thing to understand is that PFs are guided by your pre-planned wishes.
Who Can Be a Fiduciary?
It’s important to note that becoming a Professional Fiduciary in California is not a simple task. It requires a significant commitment to education and experience. To qualify, individuals must complete 30 hours of pre-licensing courses, hold at least a bachelor’s or associate’s degree with relevant experience, pass a thorough background check, and pass an exam administered by the Professional Fiduciary Association of California (PFAC). These stringent requirements ensure that professional fiduciaries are well-equipped to handle complex estate planning and management tasks.
People use professional fiduciaries for many reasons: no
children, estranged children, choosing not to include children and avoiding conflict among heirs now or after you pass. Professional Fiduciaries bring expertise and neutrality, reduce potential mismanagement’s emotional and financial costs, and avoid legal disputes. Professional fiduciaries offer a structured, professional approach to managing complex family and financial situations.
Understand The Cost
One common concern about professional fiduciaries is the cost. However, it’s important to consider the potential savings and benefits. Compared to high lawyer fees and potential family disputes, the cost of a professional fiduciary can be a wise investment. Depending on your needs, they typically charge
a percentage of the estate (e.g., 2% of the first $3 million) or an hourly rate ($175/hour and up). This cost is incurred when you use the service, whether after you pass or when you need a professional fiduciary to take over your care or finances. Ultimately, they provide peace of mind by managing the estate properly, saving time, and preserving family relationships.
Maximize Your Professional Fiduciary: Top Tips
Effective estate planning involves communication that entails naming successors (always have a backup plan). Ensure key people know how the estate plan has been completed to avoid surprises and turmoil within your family. A good PF will check in annually to learn about updates and changes. Things change in
our lives, and you want your plan to be relevant and practical. Professional Fiduciaries are an underutilized resource, often unknown to many. As always, one size fits one when choosing a professional fiduciary, so schedule an initial consultation to ensure they offer all the services you need and that your personalities match up well.
Thank you to Matthew Neal, CLPF, and Mike Novak, CLPF of ProFiduciary, Inc., for their generous time educating me on the role of a professional fiduciary. Contact (619) 501-4626 www. ProFiduciary.
Complete Real Estate Solutions
Upfront costs prevent many seniors from making the transition to Torrey Pines Senior Living. When we help you sell your home, you won’t pay those costs until after your home sells. Restrictions apply, call for details.
