Montana 55 - August 2014

Fall 2014

seniors stay active

overlooked estate planning document

vitamin d and health

2

www.montana55.com

Fall 2014

3

Fall 2014

inside 6

seniors stay active

more ways than ever to stay active

diabetes

by dillon kato

www.montana55.com

The symptoms people should be aware of as possibly being diabetes-related are increased thirst and urination, blurring of the vision, tingling or pain in the feet and occasionally unexplained weight loss.

S

Seniors are the largest group of people with diabetes in the country. According to the American Diabetes Association, more than 26 million Americans have diabetes, and people age 65 and up make up almost 11 million of them, with one in four in that age range having the disease.

Diabetes falls into two main versions, Type 1 and Type 2.

Type 1, which used to be known as juvenile-onset diabetes, was renamed because it can come at any age. It is also the far less common form of the disease, less than 10 percent of all diabetes patients.

Type 1 is an autoimmune disease, where antibodies attack the pancreas, an organ that creates insulin used turn sugars in the blood into energy. Patients have to use insulin injections to regulate their blood sugar levels.

The more common form is Type 2, which is currently seeing a massive rise in diagnosed cases, and is a strongly genetic disease.

With Type 2, the tissues in the body develop a resistance to insulin, so that the hormones the body secretes are not as effective. A patient’s pancreas is not able to keep up with the body’s demand for insulin, and often times’ the patient has to use oral medication or in advanced situations insulin injections.

If a person has a family history of Type 2, being overweight can increase the risk to develop the disease.

If patients over the age of 60 get tested and works with their primary care doctor on lifestyle changes, they can reduce their risk of Type 2 diabetes by about 70 percent, said Lisa Ranes, a certified diabetes educator and a clinical coordinator of the diabetes center at Billings Clinic. She suggested having a fasting glucose test be a part of an annual wellness exam.

Ranes, also a registered dietician, said often times older adults don’t even realize that they have diabetes.

“They might feel tired, have increased thirst and urination, but sometimes the older we get we attribute it to age and don’t get a screening,” she said.

The top priority in prevention is simple, Ranes said, cut calories and move more.

“The more fit we are, the muscles can use insulin better,” she said.

In addition to endocrinologist, Billings Clinic also has a diabetologist, as well as nurse practitioners, physician assistants and social workers who specialize in diabetes.

When working with older patients, they make sure to take into account other health concerns or medications when designing a treatment program.

They also make sure that blood sugar monitors can be easily read by someone with a vision impairment, or that an insulin pen is easy to use by someone with arthritis or dexterity issues.

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8

diabetes

10

depression

14

overlooked in Montana

When it comes to the health of seniors in Montana, the state is making incremental progress but still has significant room for improvement.

Montana ranked 30th in the nation for senior health this year, according to America’s Health Rankings Senior Report, published by the United Health Foundation.

Montana was ranked 35th last year.

Notable improvements for senior health include declines in physical inactivity, improvements in the quality of nursing home care, reductions in avoidable hospitalizations and increased preparation for end-of-life care.

The Health Rankings Senior Report is a valuable tool for understanding the key challenges and opportunities facing Montana’s senior population, said Dr. Roger Muller, medical director of UnitedHealthcare of Montana.

“With the senior population expected to double in size in the next 25 years, it is important that we develop effective programs and solutions that address seniors’ health needs in Montana and nationwide,” Muller said.

Some of the challenges that Montana faces are a shortage

28

fall & winter driving

vitamin d

for older adults

and health

by paul g. smith

www.montana55.com

Vitamin D seems to be the new vitamin C. In the ’60s, Linus Pauling made vitamin C all the rage as a cure for colds, cancer and other diseases, though with very little evidence. Now, studies of vitamin D and health are everywhere in the medical literature.

It is common knowledge that vitamin D is important for bone health helping us absorb calcium to prevent rickets and osteoporosis. But many of us aren’t aware that vitamin D deficiency might contribute to a wide variety of disorders from depression to heart disease and from infections to allergies.

So what’s the evidence that vitamin D deficiency could lead to asthma?

First, vitamin D appears to be important for normal lung development. Children born to mothers with vitamin D deficiency have smaller, less well-developed lungs and are at increased risk of asthma. Recent studies in children with severe asthma have shown a direct relationship between severity of vitamin D deficiency and airway narrowing, a major defect in asthma.

Second, vitamin D is important for immunity to infection.

Children and adults with vitamin D deficiency have more

S

Since the 1960s, asthma has increased so dramatically as to be declared an epidemic.

This increase has hit hardest in developed countries, leading us to question what lifestyle changes might be to blame.

Many hereditary and environmental factors contribute to asthma so it’s impossible to target a single cause, but one of the more intriguing possibilities is that asthma is more common when people have vitamin D deficiency. The parallels between lifestyle, asthma and vitamin D deficiency in developed countries are many and include decreased sun exposure with increased time spent indoors (especially in dark-skinned races) and poor nutrition.

Vitamin D is an essential nutrient, meaning the human body cannot make enough to prevent deficiency so diet is important. Our skin helps produce some vitamin D through sun exposure, just not enough to prevent deficiency. Because very few foods naturally contain vitamin D, we fortify milk, orange juice and other foods. Without a healthy diet, the risk of vitamin D deficiency increases.

viral infections that can cause lung and airway damage, making them more prone to asthma.

Third, people with vitamin D deficiency are at greater risk of allergies and sensitivity to inhaled irritants, making asthma more severe.

Finally, there is excellent evidence that vitamin D deficiency makes adult lung diseases such as chronic obstructive pulmonary disease worse.

But a word of caution: Though, vitamin D deficiency might lead to disease, there is no evidence that more than normal amounts are helpful. Unlike vitamin C, in which “megadoses” were very trendy and usually harmless, large doses of vitamin D can be dangerous. So good nutrition and vitamin D supplementation is important for good bone and lung health, especially in mothers and children, but don’t overdo it.

Ask your health care provider how much vitamin D is right for you or your child. In the meantime, play outside and eat healthy.

Paul G. Smith is the director of pediatric critical care and pulmonary services at Community Medical Center.

self lifting fting rrecliner

of geriatricians, a high prevalence of falls among seniors and a low percentage of health screenings among the senior population.

However, some of the state’s strengths include a low prevalence of obesity and a low percentage of hospital deaths. Also, the percentage of seniors with a dedicated health care professional increased in the past year, from 89.7 percent to 91.7 percent.

Montana is the fourth-largest state in the nation and is the third-most sparsely populated. At the same time, Montana is one of the nation’s “grayest” states – projected to have the nation’s fourth-oldest population by 2015. By 2025, one in four Montanans will have surpassed age 65 and by 2035, Montana’s senior population is set to double.

In addition, approximately 76 percent of the state’s residents call rural Montana home. The rural “frontier areas” of Montana contain more than 90 percent of the

by cingy uken

www.montana55.com

Cindy Uken is a reporter for the Billings Gazette.

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Summer 2014

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senior health

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eating habits

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and nutrition

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state’s total land area.

Those factors combine to create challenges in the state’s efforts to address the health issues of Montana’s older populations. The greatest challenge is access to care and services, said Joy Bruck, president of AARP Montana.

Given those challenges, it’s not surprising that Montana ranks 30th for senior health, she said.

Fortunately, Bruck said, Montana has a strong network of community partners dedicated to the senior sector.

“Those community partners, including AARP Montana, have been bracing for this ‘silver tsunami’ for quite some time,” Bruck said.

AARP Montana works with its community partners to hold events and seminars aimed at addressing Montana’s unique senior health care challenges, as well as educating elected officials regarding the needs and concerns of our growing older population, she said.

Richard Opper, director of the Montana Department of Public Health and Human Services, said the improvement over last year indicates that the state’s new public health initiatives are taking hold. Gov. Steve Bullock’s Health Improvement Plan is designed to help seniors live longer, healthier lives. Part of the plan supports the implementation of an evidence-based fall prevention program for seniors.

The successful Stepping On program is offered in 30 sites statewide for those who are 60 and older. The program is showing some positive results by reducing the number of falls among its participants. DPHHS also supports 35 sites in Montana with programs to implement exercise and selfmanagement programs for Montanans with arthritis and related conditions.

“It’s exciting that Montana seniors are taking advantage of these programs, which can help add more years to their lives and time spent with loved ones,” Opper said.

Minnesota is the healthiest state in the nation, followed

by Hawaii, New Hampshire, Vermont and Massachusetts.

Mississippi is the least healthy state for seniors, followed

by Louisiana (49), Kentucky (48), Oklahoma (47) and Arkansas (46).

18

4

housing

Summer 2014

32

vitamin d

34

the 4 c’s

38

leaving a legacy

42

charles m. russell

44

jewel basin

46

mission falls

and health

estate planning document

senior health

W

“A lot of people think diabetes like ‘Oh my gosh, it’s a death sentence.’ It’s 24/7, you don’t get a vacation. But in reality, if you surround yourself with a good team, the complications can be preventable,” Ranes said.

One misconception Ranes has heard is that people with diabetes have to follow a “diabetic diet,” by staying away from sweets and sugars when really, its more about just controlling the carbohydrate intake like everyone should.

“What is healthy for a person with diabetes is a diet that is healthy for average americans. Focus on timing and amounts,” Ranes said.

Having the genes for it, compounded by a lifestyle of a poor diet high in fats and carbohydrates, and not being active enough is increasing the number of people who end up developing diabetes.

“Even though there are more people with diabetes, the complications like the loss of a foot, blindness, are decreasing. Part of that is because we have goals, and we’re getting better about advising people,” said Dr. Christopher Corsi, an endocrinologist with the Western Montana Clinic in Missoula.

When he sees people diagnosed with Type 2, Corsi starts by working with them on modifying their lifestyle to better combat diabetes.

“We can’t fix the genes, so we start by working on the lifestyle choices,” he said.

In the early stages, that means a focus on better diet, more exercise and weight loss, all of which gives the patient better control over their diabetes.

Corsi said doctors tend to want to treat Type 2 with lifestyle changes alone, or with oral medications, needing insulin only in advanced cases.

The symptoms people should be aware of as possibly being diabetes-related are increased thirst and urination, blurring of the vision, tingling or pain in the feet and occasionally unexplained weight loss.

If someone comes to his office wondering if they might have diabetes, Corsi said he talks to them about any family history of the disease, but most often can do a simple blood sugar test like the ones people with diabetes use on themselves every day.

For those Type 1 and Type 2 patients who do need insulin, Corsi said technologies are getting better all the time.

“Insulin pumps used to be the size of a backpack, now they are tiny little things. They’ve just gotten better and easier to use,” he said.

Summer 2014 9

24

of choosing a medicare plan

national wildlife refuge

a pleasant hike

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www.montana55.com

the magazine for montanans in their prime

publisher mark heintzelman editor sherry devlin sales coordinator jacque walawander sales assistant holly kuehlwein

graphic designers adam potts krista ness bob jacobson

Montana 55 is a special publication of Lee Enterprises and the Missoulian. Copyright 2014.

For advertising information contact Jacque Walawander 406-523-5271, 800-366-7193, ext. 271, or email jacque.walawander@lee.net www.montana55.com

Fall 2014

5

seniors

W

stay active

With classes, programs and services all aimed at seniors, there are more ways than ever for them to stay active as they age.

6

by dillon kato

way to adapt for them.

“One guy came in with Parkinson’s, he wanted to get back into boxing. So we figured out a way to get gloves in there and spar with him as part of the exercise,” she said.

There are lots of opportunities in Missoula for older people to stay active. Blair said apart from outdoor recreation, there are plenty of indoor athletic facilities, in addition to classes aimed specifically for older people.

One of the ones she suggested are taking a fall prevention class, especially with the slippery conditions of winter approaching.

Blair, who is specially trained in arthritis patients, said she teaches senior classes in town as well. When older people have flare ups in arthritis, Blair said it is important that they keep moving and exercising, even when they don’t want to.

“With arthritis, it’s about lower impact, knowing your limits, watch when you’re doing too much,” she said.

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The Billings YMCA offers classes targeted at older adults three times a week. They include working with an instructor on balance and muscular strength, as well as teaching “chair Pilates” designed especially for older people.

“It provides flexibility and posture without having to feel like they have to continually modify. One thing we hear quite a bit is they get discouraged in other classes when they have to modify and modify to make it work,” said Kassia Lyman, health and wellness director of the Billings YMCA. Another focus of the courses is in stabilization, especially as it pertains to making sure people are comfortable walking around once the winters comes.

“We teach them to control those circumstances a little bit more, be able to build up their balance and their muscular strength so they can prevent those falls as well,” she said.

In chair Pilates, an instructor teaches the class how to use light dumbbells to do a series of exercises where the participant either stays seated in a chair or holding onto it, promoting stability. These classes also provide activities the person can do in their own homes.

Good posture is also one of the important parts for older people to think about, Lyman said.

“As we get older, we tend to hunch forward. We work to strengthen the back, stretch out the chest, and give them tips to do the same thing at home,” she said.

An activity at the YMCA that’s taken off in popularity is pickleball, a sport that plays similar to tennis on a smaller course using wooden paddles. Lyman said it has become the newest fad, and a great sport that generations of a family can play together.

“It’s cool to see, all of them just getting out there to play together, and everyone can have fun and do something as a family,” she said.

The New Directions Wellness Center, part of the University of Montana’s physical therapy program, deals with seniors who have mobility issues, and helps them to regain their motion. The issues of patients program coordinator Molly Blair sees come through the doors ranges from stroke to paralysis and arthritis. New Directions is designed to specifically work with people with those disabilities.

“Mainly, it’s just folks who used to be active wanting to continue to stay active,” Blair said.

She said these people have to start slowly on an exercise program, and that for them the goal is maintaining the motion they still have, not trying to turn them into prime athletes.

“We do a lot of stuff with a new stair stepper machine, which has low impact on the joints,” she said.

Adaptations can be made with people who have issues like paralysis, using straps for hands and legs. Balance issues are also very important, Blair said, as well as stretching activities to promote a broad range of motion. The center provides handcycles for people who can’t ride upright, and Blair said no matter what a person wants to do, there’s a

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Fall 2014

7

diabetes

S

Seniors are the largest group of people with diabetes in the country. According to the American Diabetes Association, more than 26 million Americans have diabetes, and people age 65 and up make up almost 11 million of them, with one in four in that age range having the disease.

8

by dillon kato

www.montana55.com

The symptoms people should be aware of as possibly being diabetes-related are increased thirst and urination, blurring of the vision, tingling or pain in the feet and occasionally unexplained weight loss.

Diabetes falls into two main versions, Type 1 and Type 2.

Type 1, which used to be known as juvenile-onset diabetes, was renamed because it can come at any age. It is also the far less common form of the disease, less than 10 percent of all diabetes patients.

Type 1 is an autoimmune disease, where antibodies attack the pancreas, an organ that creates insulin used turn sugars in the blood into energy. Patients have to use insulin injections to regulate their blood sugar levels.

The more common form is Type 2, which is currently seeing a massive rise in diagnosed cases, and is a strongly genetic disease.

With Type 2, the tissues in the body develop a resistance to insulin, so that the hormones the body secretes are not as effective. A patient’s pancreas is not able to keep up with the body’s demand for insulin, and often times’ the patient has to use oral medication or in advanced situations insulin injections.

If a person has a family history of Type 2, being overweight can increase the risk to develop the disease.

If patients over the age of 60 get tested and works with their primary care doctor on lifestyle changes, they can reduce their risk of Type 2 diabetes by about 70 percent, said Lisa Ranes, a certified diabetes educator and a clinical coordinator of the diabetes center at Billings Clinic. She suggested having a fasting glucose test be a part of an annual wellness exam.

Ranes, also a registered dietician, said often times older adults don’t even realize that they have diabetes.

“They might feel tired, have increased thirst and urination, but sometimes the older we get we attribute it to age and don’t get a screening,” she said.

The top priority in prevention is simple, Ranes said, cut calories and move more.

“The more fit we are, the muscles can use insulin better,” she said.

In addition to endocrinologist, Billings Clinic also has a diabetologist, as well as nurse practitioners, physician assistants and social workers who specialize in diabetes.

When working with older patients, they make sure to take into account other health concerns or medications when designing a treatment program.

They also make sure that blood sugar monitors can be easily read by someone with a vision impairment, or that an insulin pen is easy to use by someone with arthritis or dexterity issues.

“A lot of people think diabetes like ‘Oh my gosh, it’s a death sentence.’ It’s 24/7, you don’t get a vacation. But in reality, if you surround yourself with a good team, the complications can be preventable,” Ranes said.

One misconception Ranes has heard is that people with diabetes have to follow a “diabetic diet,” by staying away from sweets and sugars when really, its more about just controlling the carbohydrate intake like everyone should.

“What is healthy for a person with diabetes is a diet that is healthy for average americans. Focus on timing and amounts,” Ranes said.

Having the genes for it, compounded by a lifestyle of a poor diet high in fats and carbohydrates, and not being active enough is increasing the number of people who end up developing diabetes.

“Even though there are more people with diabetes, the complications like the loss of a foot, blindness, are decreasing. Part of that is because we have goals, and we’re getting better about advising people,” said Dr. Christopher Corsi, an endocrinologist with the Western Montana Clinic in Missoula.

When he sees people diagnosed with Type 2, Corsi starts by working with them on modifying their lifestyle to better combat diabetes.

“We can’t fix the genes, so we start by working on the lifestyle choices,” he said.

In the early stages, that means a focus on better diet, more exercise and weight loss, all of which gives the patient better control over their diabetes.

Corsi said doctors tend to want to treat Type 2 with lifestyle changes alone, or with oral medications, needing insulin only in advanced cases.

The symptoms people should be aware of as possibly being diabetes-related are increased thirst and urination, blurring of the vision, tingling or pain in the feet and occasionally unexplained weight loss.

If someone comes to his office wondering if they might have diabetes, Corsi said he talks to them about any family history of the disease, but most often can do a simple blood sugar test like the ones people with diabetes use on themselves every day.

For those Type 1 and Type 2 patients who do need insulin, Corsi said technologies are getting better all the time.

“Insulin pumps used to be the size of a backpack, now they are tiny little things. They’ve just gotten better and easier to use,” he said.

Fall 2014 9

seniors

W

with depression

While depression can affect us at any age, there are special approaches taken when dealing with depression in seniors.

10

by dillon kato

www.montana55.com

Dr. Amy Schuett, a psychiatrist with the Billings Clinic, said when she sees patients, the depression is the same, but how she goes about talking with older people about depression is different.

I might say something like, ‘How are your spirits lately?’ and talk less about physical issues,” Schuett said.

She said there is a useful tool that can be found online for family members called the short form geriatric depression scale that can help them judge depression help ask the right questions.

“Often, elderly people may be more resilient to mental health issues. There’s that attitude of go it alone, go tough, not admit to problems, a more stoic type of heritage,” she said.

When a patient with depression issues comes in, Schuett said she will look for underlying medical issues like a thyroid condition, diabetes, or infections that could be causing the person not to feel well. Then, she uses questions from the scale to gauge their mood.

“I’ll talk to them about whether they’ve dropped any of their interests or activities. Do you feel like your life is empty, are you enjoying things that you used to?” Schuett said.

A section of a person’s life she focuses on is the family. Is the person declining to go out as much or show up to family

events. Often with older people, she said grandchildren are a subject that she finds most people will normally become more talkative and interested in.

“One thing that complicates elderly depression is they can look very demented, something like Alzheimer’s that is actually depression,” Schuett said.

When tested, she will find that their memory is actually pretty good, but when she asks them questions they respond with noncommittal answers.

“Some of the problem with geriatric population is staying inside much longer. Their vitamin D goes down, which is already a problem for Montana people,” she said.

For someone with an older family member, Schuett said just getting them out into the sunlight and walking around is one of the best things that can be done to prevent depression.

“Definitely light will make a difference. if you can’t get the person out of the house, open their blinds and turn on the lights. Being available just for some casual activities can be very helpful too,” he said.

This can be particularly important if they are living alone, for example after the death of a spouse.

“Say the spouse is the one that drove, had the friends, took them places. The risk goes up,” Schuett said.

The doctor said that for older patients being treated for

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depression

For someone with an older family member, just getting them out into the sunlight and walking around is one of the best things that can be done to prevent depression.

12

www.montana55.com

depression, she also takes a different approach in how she talks to them about antidepressant medication, especially with men.

“I think men see it as a weakness more than women, feeling like they need to rely on a medication for depression,” Schuett said.

Her solution is to rephrase how she introduces them to the pills, taking a tone of what things they will help with.

Schuett said she’ll tell them about how it will help them rest better at night, or decrease their worrying, addressing some of the patients target symptoms.

The most effective way to combat depression can be a combination of these medications with lifestyle changes, Schuett said.

“Sometimes, the medications can help them get to the points where they can make the changes,” she said.

Deb Matteucci, mental health bureau services chief with the Montana Department of Health and Human Services, said while her office is not a direct service provider, they do partner with health agencies and assisted living facilities,

providing outreach and training to make them more aware of the behavioral health needs of an aging population.

One thing to look at is an older person’s general living condition in their home. If they have historically maintained flower beds, or kept their home very tidy but that has changed, Matteucci said, that could be physical discomfort, or it could be a symptom of depression.

Similarly, if they are staying in more, not engaging in their normal social groups, like a bridge or bingo night. Social supports are an important part of a healthy mind for all age ranges. Side effects of medication are also a potential cause of depression, she said.

“We just want them to really be looking at those things, not to be afraid to reach out to primary care doctors, ask questions. I think there’s a longstanding myth that depression comes along with aging, that’s just not the truth.

Reach out and get help,” Matteucci said.

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the overlooked

I

estate planning document

I have a skillet. It’s a cast iron relic weighing 5.2 pounds with the number 8 incised into the bottom.

14

by steve darty

www.montana55.com

Now logic suggests the 8 represents the diameter of the skillet, but that’s not the case. With the advent of woodburning stoves, pans were cast to fit the size of the openings in the stove tops, known as “stove eyes”. According to the 1924 Wagner Manufacturing Company catalog, a number 8 pan is designed to fit into the number 8 sized stove eye, which just so happens to be 8 7/8 inches in diameter.

Understanding the history and DNA of my skillet makes cooking with it a deeper experience.

After having lost the second of my parents, my two siblings and I found ourselves like many, sitting at a kitchen table, coming to grips with the fact our parents were no longer there. As we were going through things, we began to find notes and letters and knowing my folks, this was intended to provide us with one last adventure. And they succeeded.

One such note I found was addressed to me by my father.

It was penned with bold strokes and featured a signature worthy of a founding father. It was folded neatly and sealed inside a 1 quart Ziploc bag and left in the skillet.

The letter is private but suffices to say, Pops wanted me to have the skillet. You see, whenever he took us camping, fishing, or hunting, we brought along that number 8 skillet.

He had another that was larger, but this was the perfect

size for camping. Long enough for bacon and headless fish, but not so burdensome as a 12 incher. Whenever I see that skillet I hear, smell, and taste breakfasts from decades ago. And this past July when I took my own son camping in Glacier, you can guess the first item on the camping list.

And when we used it, we were not alone.

Now I don’t recommend leaving clues and puzzles for your children to solve, but I do recommend leaving letters.

A personal letter of instruction is the most overlooked and over-needed estate planning document and it’s one that only you can write. It can be as sterile as a checklist, or it can be a very heartfelt letter saying those things that need to be said. Either way, our loved ones need to know things like whether we have or don’t have a mini-storage unit. There’s no national registry of life insurance policies, so please, list the ones you have and if you don’t have any, let that be known. Give us a roster of your bank accounts, credit cards or debts owed, and the names and numbers of your financial advisors, insurance agents, accountants, or lawyers if applicable.

When a loved one passes, we are left with so much to process both emotionally and logistically. The last thing we need is a treasure hunt. Instead, have a 3 ringed binder and within it everything your loved ones need to know.

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the overlooked document

That way the search is limited to the front and back binder covers. This prevents the unnecessary forensic work of going through boxes, file cabinets, desk drawers the whole time wondering when it’s safe to stop looking. Your binder should include your will, your incapacity documents, and most certainly your letters.

For some time I have encouraged my young parents to write letters to their children in the event they’re not at their children’s graduations, wedding, child births, and hard times such as your own inevitable funeral. But then I realized this cobbler’s child had no shoes. So, I began writing down all of the values and traditions of my own family and the wisdom my father, mother and others

16

mentors have tried to instill in me along the way. And a funny thing happened, I began to “parent on purpose”. The act of writing down these things made me realize I better get to teaching. And though I’m far from a perfect parent, I’m now a better parent, as I now better recognize the teaching moments.

For me, it was a skillet. I couldn’t get 5 cents for my skillet, but to me it’s priceless. For your loved ones, it will be something else. No matter what it is, it will have much more meaning if they know how you feel about it, and why you are leaving it to them. And by so doing, we might just convert the ordinary into traditions.

Summer 2014

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senior health

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in Montana

When it comes to the health of seniors in Montana, the state is making incremental progress but still has significant room for improvement.

Montana ranked 30th in the nation for senior health this year, according to America’s Health Rankings Senior Report, published by the United Health Foundation.

Montana was ranked 35th last year.

Notable improvements for senior health include declines in physical inactivity, improvements in the quality of nursing home care, reductions in avoidable hospitalizations and increased preparation for end-of-life care.

The Health Rankings Senior Report is a valuable tool for understanding the key challenges and opportunities facing Montana’s senior population, said Dr. Roger Muller, medical director of UnitedHealthcare of Montana.

“With the senior population expected to double in size in the next 25 years, it is important that we develop effective programs and solutions that address seniors’ health needs in Montana and nationwide,” Muller said.

Some of the challenges that Montana faces are a shortage 18

of geriatricians, a high prevalence of falls among seniors and a low percentage of health screenings among the senior population.

However, some of the state’s strengths include a low prevalence of obesity and a low percentage of hospital deaths. Also, the percentage of seniors with a dedicated health care professional increased in the past year, from 89.7 percent to 91.7 percent.

Montana is the fourth-largest state in the nation and is the third-most sparsely populated. At the same time, Montana is one of the nation’s “grayest” states – projected to have the nation’s fourth-oldest population by 2015. By 2025, one in four Montanans will have surpassed age 65 and by 2035, Montana’s senior population is set to double.

In addition, approximately 76 percent of the state’s residents call rural Montana home. The rural “frontier areas” of Montana contain more than 90 percent of the

by cingy uken

www.montana55.com

state’s total land area.

Those factors combine to create challenges in the state’s efforts to address the health issues of Montana’s older populations. The greatest challenge is access to care and services, said Joy Bruck, president of AARP Montana.

Given those challenges, it’s not surprising that Montana ranks 30th for senior health, she said.

Fortunately, Bruck said, Montana has a strong network of community partners dedicated to the senior sector.

“Those community partners, including AARP Montana, have been bracing for this ‘silver tsunami’ for quite some time,” Bruck said.

AARP Montana works with its community partners to hold events and seminars aimed at addressing Montana’s unique senior health care challenges, as well as educating elected officials regarding the needs and concerns of our growing older population, she said.

Richard Opper, director of the Montana Department of Public Health and Human Services, said the improvement over last year indicates that the state’s new public health initiatives are taking hold. Gov. Steve Bullock’s Health Improvement Plan is designed to help seniors live longer, healthier lives. Part of the plan supports the implementation of an evidence-based fall prevention program for seniors.

The successful Stepping On program is offered in 30 sites statewide for those who are 60 and older. The program is showing some positive results by reducing the number of falls among its participants. DPHHS also supports 35 sites in Montana with programs to implement exercise and selfmanagement programs for Montanans with arthritis and related conditions.

“It’s exciting that Montana seniors are taking advantage of these programs, which can help add more years to their lives and time spent with loved ones,” Opper said.

Minnesota is the healthiest state in the nation, followed

by Hawaii, New Hampshire, Vermont and Massachusetts.

Mississippi is the least healthy state for seniors, followed

by Louisiana (49), Kentucky (48), Oklahoma (47) and Arkansas (46).

Cindy Uken is a reporter for the Billings Gazette.

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eating habits

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and nutrition

When we think about shedding pounds, we often think of restrictive diets and use such terms as “struggle to lose weight” and our new rigid “diet.” We worry about regaining the weight we have lost and then some, for good reason. Science Daily states, “Although restriction of diet often results in initial weight loss, more than 80 percent of obese dieters fail to maintain their reduced weight.”

20

by rebecca morley Perhaps there is a better and more positive approach to our relationship with food. Wouldn’t you prefer to feel great, enjoy every bite you eat and lose weight? Inherent enjoyment of food needn’t conflict with the ability to maintain a healthy weight.

A “foodie” is a gourmet, or a person who has an ardent or refined interest in food. Foodies also have an enthusiastic interest in preparing and consuming their food. Foodies eat what they really like to eat and savor the taste, texture, appearance and smell of food. The food is usually of high quality, not highly processed and prepared, as we used to say, “from scratch.” And the ingredients tend to vary from dish to dish, which increases our exposure to a variety of essential nutrients.

Maybe it is time for boomers to take back their kitchens with renewed vigor. If it takes time to make a meal or snack, this extra time and care may help us value the food we prepare. But don’t think that being a foodie means you need to spend hours in the kitchen. Sometimes a juicy piece of fresh, seasonal fruit and a handful of nuts is all that is needed to satisfy hunger.

By taking more time to eat – enjoying each mouthful – you may find you are satisfied with smaller portions. You may be surprised when you step on the scale to find that your weight has dropped because you are not reaching for

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junk food or overeating.

Using a kinder approach to eating, become a foodie who is a mindful eater. Learn to eat when hungry and stop when you are full. Another term might be “intuitive eating.”

According to registered dietitian Evelyn Tribole and registered dietitian and nurse Elyse Resch, co-authors of the book “Intuitive Eating,” the underlying concept is that you can learn to respond to your inner body cues, because you are born with all the wisdom you need for eating intuitively. If this style of eating appeals to you, just google “intuitive eating” and you will find a link to a website that lists 10 intuitive eating principles. Whereas most diets focus on external factors such as calorie counting and methods to control your weight, intuitive eating encourages you to focus intrinsically and listen to your mind and body.

We needn’t drown our food in butter and heavy cream to consider ourselves foodies. Instead, think of yourself as a “health foodie.” Purposely use a variety of spices fresh fruits, vegetables, whole grains and lean meats to prepare tasty dishes from scratch. Proudly incorporate lots of fresh, locally grown ingredients whenever possible. Cultivate a love, interest, respect and appreciation for food. Learn to listen to your hunger cues and stop eating when you are satisfied.

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eating habits Here are some ideas for budding healthy foodies:

• Make it a point to try at least one new food per week.

• Explore food from other cultures.

• Hang out at the farmers market. Ask vendors how to prepare various items from their displays that are unfamiliar to you.

• Ask for recipes of dishes you particularly enjoy from your favorite restaurant.

• If you enjoy wine, go to a wine-tasting event to learn about how different flavors develop, and which wines should be paired with which foods.

• Take a cooking class.

• Use quality ingredients in your cooking such as real vanilla, extra virgin olive oil, fresh herbs and balsamic vinegar.

• Invest in tools of the trade, such as decent knives and other basic kitchen utensils you have done without in the past.

• Get to know other foodies in your community.

Share recipes, ideas and meals.

• Limit recipes that are unusually high in saturated fat, sugar or salt or make substitutions with healthier options • Start small as you begin your gourmet dish expansion. Perhaps try making your own mayonnaise or garden-fresh salsa. Experiment with lemon juice instead of salt as you prepare baked chicken or fish. Try a homemade marinade on your favorite barbecue.

Boomers often have more time for hobbies as the children leave the nest and they feel secure in their careers.

Gourmet cooking can become your new hobby. Perhaps you have a partner who would be willing to join you in this new venture. There are a variety of food channels that can initiate ideas and teach techniques that allow you to “whip things up” in your own kitchen. Shared cooking can be a fun way to bond as you develop a positive approach to the entire process of planning, preparing and enjoying the results.

Try to look at food as an exciting experience, from shopping for ingredients to the art of preparation, including the aesthetics of a dish and how it’s presented. It can be fun to break out the good dishes and serve a meal by candlelight now and again. Use special meals as social occasions, inviting your favorite friends to enjoy your culinary delights. When you eat what you really like in an environment that is inviting, the pleasure that you derive may help you feel content and satisfied with smaller portions.

22

An advantage will be that you know the ingredients that go into the dishes you prepare. You can avoid the hidden sugar, salt and fat in many processed foods. Have you ever read the label of a packaged bakery item with dozens of ingredients that you cannot pronounce much less define?

When you cook in your own kitchen from wholesome ingredients, there is a reduction in chemicals that may not promote your health, such as artificial flavors, colors and other shelf life extenders.

A “health foodie” goes beyond the typical gourmet by connecting food with health. It includes the science of nutrition and subsequent incorporation of a variety of wholesome foods that help prevent diseases or assist in managing them.

The idea of a gourmet cook is not new, but foodies usually have a more intense and constant relationship with food, rather than cooking an occasional special meal. And just like healthy gourmet cooking, a health foodie uses quality ingredients that are known to be beneficial to our health.

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The future of health foodies includes a collaboration of doctors, farmers and chefs to advocate for the role that nutrition can play in overall wellness. Using scientific methods to identify which foods support health and in what frequency and proportion is extremely important. But it is not enough. What really encourages people to eat more of these healthful foods is to show how delicious, affordable and easy to prepare they can be.

Food can be both enjoyable and a foundation for a healthy lifestyle. Of course, we can’t neglect the vital component of regular daily exercise if we want to look and feel our best. But combining the best of enjoying our food and physical activity will pave the road for wellness.

Perhaps it’s time to quit obsessing over calories and instead focus our attention on our food, enjoying it fully, including how it makes us feel as well as how it tastes.

You’ll be amazed at what it can do for health and your waistline.

Rebecca Morley provides nutrition services through the Eat Smart Program and can be reached at 258-3827 or at rmorley@co.missoula.mt.us.

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housing

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for older adults

Earlier this year, the Joint Center for Housing Studies of Harvard University released a new report commissioned by AARP titled “Housing America’s Older Adults: Meeting the Needs of an Aging Population.”

24

by george masnick

The report noted that most older households-and particularly owners-prefer to remain in their own homes as they age.

With age, people are increasingly likely to face disabilities that pose challenges to living independently. The aging of the Baby Boom generation will sharply increase the numbers of older adults with physical and cognitive limitations.

Millions of older adults who develop disabilities live in homes that lack accessibility features such as a no-step entry, single-floor living, extra-wide doorways and halls, accessible electrical controls and switches, and lever-style door and faucet handles. Indeed, the 2011 American Housing Survey reports that just 1 percent of U.S. housing units have all five of these universal design features.

Roughly two in five housing units in the country have either none or only one of these features. Over 60 percent of persons over the age of 80 have some disability affecting their activities of daily living, but just 30 percent of homes they live in have at least three accessibility features.

About 10.3 million households aged 50 and over report

having someone at home with serious difficulty walking or climbing stairs. At the same time, 5.5 million of these households also report having to climb stairs to enter or exit their homes. Given the characteristics of the existing housing stock, many older adults will have to make modifications to their homes to accommodate the physical limitations that arise with age if they are to be able to safely stay in their homes.

Falls are the no. 1 cause of injury and injury-related deaths among adults aged 65 and over. The Centers for Disease Control and Prevention estimates that the real cost of falls to the U.S. health care system in 2010 was $30 billion. In that year,2.3 million older adults were treated for nonfatal fall injuries in emergency departments, with roughly 29 percent resulting in hospitalization. Injuries from falls often reduce mobility and independence, and the decrease in physical activity post-injury raises the likelihood of other falls. This undermines confidence and physical activity, creating a vicious cycle.

But several simple, low-cost measures can go a long way toward preventing these accidents: removing tripping

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The AARP Automobile & Homeowners Insurance Program from The Hartford is underwritten by Hartford Fire Insurance Company and its affiliates, One Hartford Plaza, Hartford CT 06155. CA license number 5152. In Washington, the Auto Program is underwritten

by Trumbull Insurance Company. The Home Program is underwritten by Hartford Underwriters Insurance Company. AARP does not employ or endorse agents or brokers. AARP and its affiliates are not insurers. Paid endorsement. The Hartford pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP membership is required for Program eligibility in most states. Applicants are individually underwritten and some may not qualify. Specific features, credits, and discounts may vary and may not be available in all states in accordance with state filings and applicable law. You have the option of purchasing a policy directly from The Hartford. Your price, however, could vary, and you will not have the advice, counsel or services of your independent agent.

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hazards such as slippery area rugs, installing grab bars in bathrooms and railings on both sides of stairs, and improving the lighting around the home and on outdoor walkways. The CDC also recommends a number of health and wellness practices to prevent falls, including having regular eye exams, evaluating medications for side effects, and promoting exercise for balance.

Helping our seniors to safely age in place should be a high priority for all concerned – from national, state and local governments, to the insurance industry, hospitals and extended families, down to the seniors themselves. Many efforts are underway to improve the housing of today’s and tomorrow’s aging population, by adjusting building code regulations, by providing tax incentives for improvements, by providing grants and loans to do the work, and by volunteer assistance.

The Joint Center/AARP report is far-reaching in its analysis of this problem and in its recommendations.

It can be found online at jchs.harvard.edu/research/ housing_americas_older_adults.

George Masnick is a senior research fellow at the Joint Center for Housing Studies of Harvard University and a volunteer at Providence St. Patrick Hospital in Missoula.

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fall & winter driving

This question came in from Karen who stopped by our booth during our Day of Service in Butte.

Q:

We bought our granddaughter her first car as she headed off to college this fall. I am worried about her driving during the winter months. What tips or advice do you have that I can provide to her?

28

A:

Whether you are new to auto ownership or a seasoned, long-time owner, the time to prepare for winter driving is before the snow flies. As we know in Montana, we can get snow any month of the year, but our winter driving season is nearly upon us. Driving in winter weather -- snow, ice, wet and cold -- creates a great challenge for vehicles and drivers. Keeping your vehicle in good technical repair reduces your overall chances for mishaps, accidents or disaster while driving in winter weather.

by stacia dahl, montana aarp

www.montana55.com

Prepare yourself for the winter driving season by following these five tips.

replace your windshield wipers and install snow tires for better traction.

1.

3.

Listen up: If you’ve been hearing any unusual noises while driving be sure to check out the source of those sounds. Starting out fresh should keep your driving safe through the snowy season. If you’ve been hearing your brakes screech or make other unusual sounds it’s time to check out those noises. If your brakes are making noise, check your brake fluid. Brake fluid attracts moisture, which could freeze in the winter and create travel issues. So when the cold air hits, be sure to change your brake fluid to start winter with fresh, dry (no water content) brake fluid in the system. Be sure to use high quality brake fluid, as it will prove more cost effective in preventing winter car troubles.

This will leave you with a dry system protected from moisture and rusting during the winter.

2.

Tune up: Schedule a winter check-up for your vehicle.

Have a trained technician inspect your vehicle with special attention to parts vulnerable in winter, such as the battery, engine and brakes. Make sure the technician also checks that your car’s heating and air conditioning system and lights are working properly, and that your exhaust system isn’t leaking. Winter is a great time for you to

Clean up: Give your vehicle a “winter cleaning” inside and out. A basic car wash is a good place to start to ensure your exterior is prepared for the barrage of snow and salt, and to also make sure your lights and mirror aren’t obstructed by any dirt. You can also switch out your floor mats for weather resistant mats so they don’t get slippery on snowy days. Most importantly, clean out your trunk to make space for essential winter season supplies like a scraper and shovel.

4.

Stock up: While you should always have an emergency roadside kit in your vehicle, winter is the time to check the contents and add the winter necessities.

Stock the everyday essentials – flashlight, flares, first aid kit, jumper cables, tool kit, paper towels, extra windshield washer fluid, and food and bottled water. Be sure to also pack the more winter-specific items, such as a blanket, hats and gloves, a snow brush, ice scraper, tire chains, snow shovel, and even a bag of salt or kitty litter for added traction in case a tire gets stuck. It’s also smart to keep a pair of winter boots in your trunk in case you need to exit your vehicle in an emergency.

Let us help heat your home This winter, we’re helping keep families safe and healthy by assisting with home heating costs. NorthWestern Energy customers who qualify for the Low Income Energy Assistance Program (LIEAP) may receive a discount on their electric and natural gas bills. Customers who rent or own their homes may also be eligible for free weatherization measures.

To apply, contact the Human Resource Council at 406-728-3710.

Fall 2014

29

fall & winter driving 5.

Fill up: Always keep your gas tank at least half-full.

In the winter months, an empty gas tank runs the risk of freezing, whereas a fuller tank prevents moisture from building up and even adds a beneficial weight increase to your vehicle. In addition to your gas tank, fill up on new oil and make sure your anti-freeze is full and contains the appropriate mix (about a 50/50 mix of water and antifreeze).

Understanding how to prepare your vehicle for harsh weather conditions can protect you, your passengers and your vehicle. But winter weather also requires cautious driving.

30

If you feel you could use a winter driving refresher, consider taking the AARP Smart Driver™ Course. For more information, visit www.aarp.org/safedriving or call 1-888-AARP-NOW (1-877-846-3299).

Do you have a question for AARP Montana? Send your question to “Ask AARP Montana” at MTAARP@aarp. org or 30 W 14th St., Helena, MT 59601 or call our toll-free hotline at 866-295-7278. As we receive questions, we will consult with both internal and external experts to provide timely and valuable advice.

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vitamin d

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and health

Since the 1960s, asthma has increased so dramatically as to be declared an epidemic.

This increase has hit hardest in developed countries, leading us to question what lifestyle changes might be to blame.

32

Many hereditary and environmental factors contribute to asthma so it’s impossible to target a single cause, but one of the more intriguing possibilities is that asthma is more common when people have vitamin D deficiency. The parallels between lifestyle, asthma and vitamin D deficiency in developed countries are many and include decreased sun exposure with increased time spent indoors (especially in dark-skinned races) and poor nutrition.

Vitamin D is an essential nutrient, meaning the human body cannot make enough to prevent deficiency so diet is important. Our skin helps produce some vitamin D through sun exposure, just not enough to prevent deficiency. Because very few foods naturally contain vitamin D, we fortify milk, orange juice and other foods. Without a healthy diet, the risk of vitamin D deficiency increases.

by paul g. smith

www.montana55.com

Vitamin D seems to be the new vitamin C. In the ’60s, Linus Pauling made vitamin C all the rage as a cure for colds, cancer and other diseases, though with very little evidence. Now, studies of vitamin D and health are everywhere in the medical literature.

It is common knowledge that vitamin D is important for bone health helping us absorb calcium to prevent rickets and osteoporosis. But many of us aren’t aware that vitamin D deficiency might contribute to a wide variety of disorders from depression to heart disease and from infections to allergies.

So what’s the evidence that vitamin D deficiency could lead to asthma?

First, vitamin D appears to be important for normal lung development. Children born to mothers with vitamin D deficiency have smaller, less well-developed lungs and are at increased risk of asthma. Recent studies in children with severe asthma have shown a direct relationship between severity of vitamin D deficiency and airway narrowing, a major defect in asthma.

Second, vitamin D is important for immunity to infection.

Children and adults with vitamin D deficiency have more

viral infections that can cause lung and airway damage, making them more prone to asthma.

Third, people with vitamin D deficiency are at greater risk of allergies and sensitivity to inhaled irritants, making asthma more severe.

Finally, there is excellent evidence that vitamin D deficiency makes adult lung diseases such as chronic obstructive pulmonary disease worse.

But a word of caution: Though, vitamin D deficiency might lead to disease, there is no evidence that more than normal amounts are helpful. Unlike vitamin C, in which “megadoses” were very trendy and usually harmless, large doses of vitamin D can be dangerous. So good nutrition and vitamin D supplementation is important for good bone and lung health, especially in mothers and children, but don’t overdo it.

Ask your health care provider how much vitamin D is right for you or your child. In the meantime, play outside and eat healthy.

Paul G. Smith is the director of pediatric critical care and pulmonary services at Community Medical Center.

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the 4 c’s

of choosing a medicare plan

This question came from Nicole during our Day of Service Shredding event and Food Drive in Missoula.

Q:

My mother just turned 68 and she was recently diagnosed with diabetes and high blood pressure. As a result, she had unexpectedly higher doctor and prescription drug bills. Her doctor’s financial counselor suggested we re-examine her Medicare choices when the next open enrollment period begins so she can switch to a plan that better meets her health needs and her financial situation.

When is Medicare Open Enrollment this year and what suggestions do you have for us to consider?

A:

This year’s Medicare open enrollment season runs from October 15 – December 7.

If you’re 65 or over, you can review your Medicare options and change plans if you’d like. In fact, each year you have a chance to review your coverage and see what new benefits Medicare has to offer.

Generally speaking, if you’re satisfied that your current plan will meet your needs for the next year, you don’t need to make any changes.

But if you need to find a plan that works better for you, be sure to spend time doing your homework during Medicare’s open enrollment so that you have the health and prescription drug plans that work best for you.

I encourage you to take some time to get to know how your Medicare works. Visit the AARP Medicare Question and Answer tool at www.aarp.gov/MedicareQA to find answers to common questions.

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the 4 c’s

of choosing a medicare plan What to Consider When Selecting a Medicare Plan

You can compare Medicare coverage options on the Medicare Plan Finder at www.Medicare.gov. Click on “Find Health & Drug Plans.” When looking at your options, consider the four C’s: coverage, cost, convenience and customer service.

1. Coverage

Make sure that the doctors you see and the medications you take will still be part of your plan in the coming year.

If upcoming plan changes affect your coverage, then it’s important to review other Medicare coverage options.

2. Cost

Like most other insurance, Medicare does not pay for all your health care costs. You are responsible for paying for expenses such as deductibles, coinsurance and co-payments.

If two or more plans seem to offer about the same coverage, consider choosing the plan with the lowest overall cost.

Remember, don’t just look at the premium (monthly payment). Also consider the deductible (how much you pay out-of-pocket before insurance kicks in), and coinsurance and copayments (how much you pay out-of-pocket for each service like visiting a doctor or filling a prescription). Make sure to compare all of these features so you can find a plan that works for you and your wallet.

3. Convenience

Compare plans to see which doctors and hospitals are included in the coverage, as well as what local pharmacies participate. If you prefer mail-order pharmacies, check out which plans offer this option.

4. Customer Service

The Medicare plan finder tool on www.Medicare.gov provides a quality rating for each plan. The rating covers several aspects of each plan, including customer service, member complaints, drug pricing, managing chronic conditions and more.

All plans now cover certain preventive services at no cost to you, thanks to the Affordable Care Act. These include screenings like mammograms and colonoscopies and annual wellness visits with your doctor.

For one-on-one help with your Medicare decisions, contact The Montana State Health Insurance Assistance Program (SHIP) -- a free health-benefits counseling and advocacy service for Medicare beneficiaries and their families or caregivers. A SHIP counselor can be reached at 1-800-5513191.

Changes to plans can be made at Medicare’s website, www. medicare.gov

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Do you have a question for AARP Montana? Send your question to “Ask AARP Montana” at MTAARP@aarp.org or 30 W 14th St., Helena, MT 59601 or call our toll-free hotline at 866-295-7278. As we receive questions, we will consult with both internal and external experts to provide timely and valuable advice.

by stacia dahl, mt aarp

www.montana55.com Euthanizing Medicine?

Join Dr. David Stevens for an in-depth look at the dangers of legalizing physician-assisted suicide During the session, we will: ■ Review the history and roots of this movement ■ Examine the arguments for and against it ■ Discuss the effect it will have on healthcare professionals, families, patients and our society

Bozeman Deaconess Hospital, Bitterroot/Meadowlark Room Monday, November 17, 2014 from 6-7:30 PM Billings St. Vincent’s Hospital Burns Auditorium - Mansfield Center Tuesday, November 18, 2014 from 7-9 PM Great Falls Heritage Hall at the MSU Campus Wednesday, November 19, 2014 at 7 PM Kalispell Regional Medical Center, Buffalo Hill Conference Center Thursday, November 20, 2014 from 12:15-1:15 PM Kalispell - Glacial Forum, Sykes Diner Thursday, November 20, 2014 at 6:30 PM University of Montana Missoula, RM 169 Skaggs Bldg.

Friday, November 21, 2014 from 7-9 PM

preventassistedsuicide@gmail.com Guest Speaker David Stevens, MD, MA (Ethics) Dr. David Stevens serves as Executive Director of the American Academy of Medical Ethics, a non-profit organization that exists to educate individuals and organizations on such pressing bioethical issues of today as reproductive technology, cloning, genetics and end-of-life care. The mission of the American Academy of Medical Ethics is to educate and equip with ethically sound scientific studies, interpretation and resources from the country’s most qualified healthcare professionals and academicians. Dr. Stevens holds a degree from Asbury University and is an AOA graduate of the University of Louisville School of Medicine. He is board certified in family practice. He earned a master’s degree in bioethics from Trinity International University in 2002, graduating summa cum laude.

Fall 2014

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leaving a legacy

S

STEVENSVILLE – They say a photograph is worth a thousand words. But sometimes that single moment captured in time can be so much more.

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by perry backus

www.montana55.com

Dale Burk knows all about that.

The Stevensville man has always found his peace along the riffles and pools of a good trout stream.

He’d always hoped to leave his children and grandchildren with that.

Over the decades, Burk made a point of starting their instruction into the finer points of fly fishing when each one his five children and four grandchildren turned 6.

It required patience and love.

“The first thing I taught them was how to work a fly rod correctly,” Burk said. “In those early years, they needed lots of help as they learned how to reach out to make a longer cast and to place their fly in just the right location.”

He taught them how to read the river, too.

He showed them those places where they’d most likely find a feeding trout. He showed them the still waters behind large rocks favored by fish and the feeding lanes along the cut banks on the river’s edge. He showed them how to present their flies just right to an actively feeding trout.

“When you do things right most of the time, good things

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tend to happen,” Burk said.

Burk learned those same lessons in his 20s from some of the finest fishermen to cast a fly on the Big Hole River.

“It’s really where I got hooked on fly fishing,” he said.

If you have a minute, Burk will tell his best fishing story of the big one that got away. He’s been searching for it ever since.

That happened on the first day that Butte’s famous fly shop owner, Fran Johnson, offered to take him for a float down the lower Big Hole near Melrose.

Burk was still a beginner then.

“I had never used streamers before that day,” Burk said.

“I’d fished most of the day without much luck when Fran directed me to try a streamer in a nice hole.”

His rod bent double and the fight was on.

“About 30 or 40 minutes later, there was Fran kneeling on the bank and holding one of the largest fish I had ever seen,” Burk said. “He carried one of those little tape measures and scales in his pocket.”

Johnson’s scale tipped 12 pounds, four ounces.

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leaving a legacy “I was going to keep that fish,” Burk said. “It was before I had learned about catch and release, but it took a mighty flop and sailed right back into the river. Just like that, I had lost a fish of a lifetime.

“I’ve only caught one other brown trout since then that even came close,” he said. “I was ruined for life.”

But he never quit fly fishing.

He passed along everything he’d learned over thousands of hours of casting and catching trout to his kids and their kids, too.

There’s pride in his voice when he says they’ve all become good fishermen in their own right.

Burk’s youngest grandchild, Ted, turned 9 this year. He’d already been through those first lessons on casting, setting the hook and reading the river.

When he came to stay with his grandparents for a few weeks this summer, the young boy proudly told Burk he was ready to do everything himself.

“The first thing he says when he gets here in the summer is ‘can we go fishing tomorrow?’ ” Burk said.

All summer long, Ted listened and learned as his grandfather offered him tips on his casting form and tested him on what he’d learned over the past few years.

Like all summers, this one came to an end a few weeks

ago.

When their raft pushed off from the banks of the upper Bitterroot River, they all knew this was the last float trip of the season.

It was one of those late summer afternoons where the air was warm and the cottonwood’s changing leaves created reflections that turned the waters of the Bitterroot River golden. Caddis flies dappled the shimmering waters and the fish were rising.

The youngster asked for one of his grandfather’s handtied size 14 red-bodied caddis flies.

“I asked him to look and see what they were feeding on,” Burk said. “I told him to tell me what he’s seeing. He asked for the caddis.”

Burk watched as his grandson placed that caddis perfectly in a feeding lane right along the bank.

Bam! The boy’s rod bent double as he carefully fought the large and colorful cutthroat back to the raft where Burk’s son-inlaw, Joe Gordon, was waiting with a net.

A few minutes later, the fish was caught and a beaming 9-year-old was staring at his prize dripping in the net right before his face.

Click.

Burk captured the moment with his camera.

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“It was one of those perfect days of late summer that we all look forward to seeing,” Burk said. “It was made more perfect by happenstance when I managed to capture the absolute moment of joy and pride that filled that young boy’s face.”

Burk had always hoped that his children and grandchildren might experience the same feeling of peace and contentment that he’s had all these years on the river with a fly rod in his hand.

“When I began all of this, I think it was more to see if they would find the same enjoyment and release that I’ve found in the experience of fishing,” he said. “In that single photo, it’s now all locked in. I know that’s happened.”

“I’ve always taken my fly fishing seriously,” Burk said.

“I later developed my skills as a fly tier. Beyond those two endeavors, it’s been the great joy of my life introducing my children to fly fishing. … It’s a delight to know that I’ve been able to pass that heritage from one generation to the next.”

Burk knows his grandson is already looking forward to next summer’s adventures on the Bitterroot.

Next summer, there’s going to be something new.

“He’s going to be expected to row.”

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406.651.6500 www.riverstonehealth.org Billings, Montana Fall 2014

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charles m. russell

Fort Belknap

Harlem Malta

Milk Riv er 191

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FORT PECK 13 INDIAN RESERVATION

Fort Peck Reservoir

Charles M. Russell National Wildlife Refuge

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LEWISTOWN – There is no heart of the Charles M. Russell National Wildlife Refuge, but there is a circulatory system.

national wildlife refuge

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This 1.1-million-acre, 125-mile-long territory along 87 12 94 Harlowton the Missouri River Breaks has long been known as the 12 Miles City Roundup o t n e R s i v e r w o “American Serengeti” by generations of big-game hunters Yell To Billings Forsyth who’ve made pilgrimages there.

Outside of hunting season, the area offers scenery unlike KEN BARNEDT/Missoulian Ekalaka Colstrip e any other part of Montana, stunning herds of elk wandering i R probe balls of soon-to-be-hibernating rattlesnakes, much er as they did when Meriwether Lewis and William Clark first to their dismay.

Herds of antelope gallop across the prairie, passed through, and isolation that belies the network of roads er R iv showing the inexhaustible speed that’s allowed them to seen on a map. escape Ice Age and modern-day predators.

Most people come to the CMR’s west end from U.S. The U.S. Fish and Wildlife Service manages the CMR and Highway 191 north of Lewistown, although the Fort Peck the interior UL Bend National Wildlife Refuge and UL Bend Lake area to the east draws anglers and boaters. In between Wilderness. lie the Breaks – thousands of gullies, coulees, dry riverbeds This last finger of land, bounded by the hose-kink of the and canyons that make the country look like a shattered pane Missouri River on three sides, is a fully protected landscape of glass from the air. with rules similar to the Bob Marshall Wilderness Complex.

This landscape holds bizarre secrets. Hikers have literally This often catches hunters by surprise when they learn they stumbled across nearly complete dinosaur skeletons recently can’t use a wheeled game cart to lug their elk to camp. eroded out of cliff walls. In the fall, hunting dogs occasionally

by rob chaney

www.montana55.com

Visitors to the CMR must always watch the weather. Winter storms hit here with “Made in North Pole” stamps still leaking ink, while a rain cloud at any other time of the year is a warning to get out – fast. What looks like high desert turns to gumbo mud in even light rain, making roads impassable and even walking treacherous until things dry out.

Don’t Be!

getaway Location: The Charles M. Russell National Wildlife Refuge field office is located in Lewistown, which is about 65 miles southwest of the western edge of the refuge on U.S. Highway 191.

Distance/duration: Slippery Ann Elk Viewing Area lies about 6 miles east of Highway 191’s Fred Robinson Bridge across the Missouri River and the adjacent James Kipp Recreation Area. Front-country camping is available at the recreation area, and at-large camping is allowed within 100 yards of the river or numbered roads.

Difficulty: While apparently flat, the Missouri Breaks can be tiring due to constant up-and-down climbing of gullies and ridges. Beware of cactus spines, rattlesnakes and rainstorms.

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Fall 2014

43

jewel basin

a pleasant hike

Rob Chaney

B

BIGFORK – The “high” part of high mountain lakes can discourage some hikers, so that’s where the Jewel Basin comes in handy.

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by rob chaney

www.montana55.com

A well-maintained U.S. Forest Service road acquires most of the elevation gain as you motor 2,500 vertical feet above Bigfork and Flathead Lake to the unfortunately named Camp Misery. It’s really a parking lot and trailhead entry.

The basin holds 15,349 acres, 35 miles of trails, 27 named lakes and beauty. And it’s accessible to hikers in summer and fall, and to backcountry skiers in winter.

The 6-mile loop route to Mount Aeneas is so accessible, many people climb it on the night of the Fourth of July to watch fireworks explode up and down the Flathead Valley.

It’s 22 miles round-trip to Big Hawk Lake, making it a good link for a multi-day backpacking excursion. One common complaint is there are so many trails interlacing this compact area, it’s easy to wind up at the wrong lake.

Designated campgrounds await at Crater, Birch, Inthalm-keh and numerous other lakes, and undesignated sites can be found at most of the other large water bodies.

Please be considerate of the amount of use this convenient area gets and practice leave-no-trace camping.

Hardy skiers skin into the Jewel Basin to carve turns around the “snow ghosts” – trees flocked in crystallized snow. Motorized, bicycle and horse use is prohibited in the Jewel, making it a hiker’s and skier’s playground. Dogs are allowed, but must be kept on a leash.

While not a designated wilderness area, the “hiking area” designation achieved in 1970 prevented the basin from being overwhelmed by motorcycle use.

Climbers enjoy views into Glacier National Park to the north and the Bob Marshall Wilderness to the east from most of the five named mountains and 11 unnamed peaks in the basin.

The Montana Department of Fish, Wildlife and Parks recently completed an effort to remove non-native rainbow trout from many of the Jewel Basin lakes and restock them with native westslope cutthroat trout.

getaway Location: Northeast of Bigfork in the Swan Mountains, following Highway 83 to Echo Lake and then Forest Service Road 5392 to Jewel Basin Hiking Area.

Distance/duration: Jewel Basin offers everything from half-mile saunters overlooking the Flathead Valley to 30-mile round-trip backpacking opportunities.

Difficulty: Easy to strenuous, depending on how far you want to go.

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mission falls

an unforgettable view

MICHAEL GALLACHER

S

ST. IGNATIUS – It’s a favorite view for many Montanans, when they top Ravalli Hill on U.S. Highway 93 west of here and the Mission Mountains explode into view, with a magnificent waterfall tumbling down them.

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With a recreation permit from the Confederated Salish and Kootenai Tribes – who 32 years ago became the first American Indian tribe to ever permanently designate some of their own lands as a wilderness area – you can get a lot closer.

There’s something here for all ages and abilities.

While it would be hard to argue that the reservoir itself is “wild,” given that it was created by a man-made dam likely built in the 1930s, there’s no denying the stunning lake-like scenery it created.

The reservoir is a beautiful spot to picnic, camp or fish (make sure you have the proper stamps on your permit for the latter two activities). There are three areas available for mostly primitive camping.

The first you’ll arrive at is on the northwest side of the reservoir, and the second is at the east end of the reservoir. Both have restroom facilities.

People also camp at the Mission Falls trailhead at the end of the road, although there are no restrooms there.

by vince devlin

www.montana55.com

ion iss M

Here’s what you should know about the trail itself. That spectacular waterfall you see from Highway 93? That’s MISSION Kicking Elizabeth Falls, and it’s farther above the waterfall most Horse MOUNTAINS Mount Calowahcan Reservoir WILDERNESS people hike to.

The 2-mile trail leads to Mission Falls, spectacular in its Allentown Charlo own right.

Mission Falls can be deceivingly dangerous, according to MISSION Weisner Ninepipe MOUNTAINS Peak Reservoir Tom McDonald, division manager of CSKT’s Department McDonald TRIBAL Lake of Fish, Wildlife, Recreation and Conservation. The trail, WILDERNESS which includes three steep sections, takes you to a pool McDonald Glacier McDonald atop the falls that couldn’t look more serene.

Peak FLATHEAD West McDonald “A light film of algae grows on the rocks, and people INDIAN Peak Panoramic who wade out into the pool can slip and go over the falls,” RESERVATION Peak McDonald says. “It’s the only trail in the wilderness we’ve Glacier Peaks Mount had fatalities on in my time here.”

Kakashe Mountain Shoemaker 93 Mission Falls Stay out of the water and you won’t slip on the algae.

Mountaineer The trail continues another 3 to 4 miles to Lucifer Lake.

Mission Peak ek Elizabeth k Mission Dam Reservoir e r C Falls It is extremely steep, not maintained, and doesn’t offer National campground on i s s Lowary Mi St. Ignatious Mission Dam Road good vantage points for viewing Elizabeth Falls, which it Bison Range Peak Lower Mission Falls passes. campground West e Cr

e

Vince Devlin is a reporter for the Missoulian.

N Ravalli

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St. Marys Peak East St. Marys Peak Gray Wolf St. Marys Peak Lake KEN BARNEDT/Missoulian

Act Now to Keep Death with Dignity Legal in Montana!

The Supreme Court’s 2009 Baxter decision made Montana one of the few states to allow aid in dying. Now, some groups won’t stop until they take that right away from us.

You can help.

Sign and return this petition today to protect your right to a peaceful death.

compassion & choices

The humaniTies—history, literature, philosophy, cultural studies, ethics, and more—encourage Thinking, creaTe knowledge, and inspire delighT. We

support public programs that explore and deepen our understanding of our roles in The conTemporary world. Help us make a difference. Donate today.

montana

Support. Educate. Advocate. Choice & Care at the End of Life.

I support the Baxter decision!

Name Address Phone Email Want to learn more or volunteer?

Scan this code with your smart phone or call Amy at 406-552-2916 www.compassionandchoices.org/montana Send your completed petition to: Compassion & Choices Montana, PO Box 1348, Helena MT 59624

www.humaniTiesmonTana.org Fall 2014

47

Each day to the Each day fullest. to the fullest.

The secret to happiness as we The secret to happiness as we age is to stay as mentally, physically and socially age is to stay as mentally, physically and socially engaged as possible. To feel a sense of purpose. And to be The secret to wefeel a sense of purpose. And to be engaged ashappiness possible.asTo surrounded by those who truly care.

Helping residents live each day to the fullest is our age is to stay asby mentally, andcare. socially surrounded those physically who truly Helping residents live each day to the fullest is our missionasatpossible.

Highgate.

We offerofapurpose. host ofAnd activities, engaged To feel a sense to be nutritious and delicious meals, and mission at Highgate. We offer a host of activities, nutritious and delicious meals, and surrounded by those truly care.

Helpingsetting. residentsIflive to loved the fullest our full care for all in who a lovely, homelike youeach or day your oneis needs either a full care for all in a lovely, homelike setting.

If you or your loved one needs either a mission at aHighgate.

We offer activities, nutritious and delicious meals, and little or lot of extra helpa host withofdaily living, call today and schedule a tour of our little lotinof extrahomelike help with dailyIf living, call today andneeds schedule full careorfora all a lovely, setting. you or your loved one either aa tour of our Assisted Living or Memory Care community. You’ll see why a move to Highgate is one little or a lot of extra with daily living, call today and schedule touraofmove our to Highgate is one Assisted Living or help Memory Care community.

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Assisted or Memory of the Living best moves youCare cancommunity. make. You’ll see why a move to Highgate is one of the best moves you can make.

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