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He lthy L ving SpeciaL advertiSing Feature
tulsaworld.com/healthyliving
Caring for aging parents takes wisdom, planning By Stefanie Forney Special Sections Editor
Getting older is something we all face. Not only are our own needs changing, but many of us are, or soon will be, caring for an aging parent. Understanding their needs and providing the right assistance at the right time can be stressful and exhausting. The number of “unpaid family caregivers” is estimated to reach 37 million by 2050, an 85 percent increase from the year 2000, according to the Family Caregiver Alliance. You can help your parents maintain their independence as long as possible by having important conversations now and taking some steps to prepare for the future. “I always encourage aging parents to maintain an active lifestyle (i.e.: senior exercise groups) when they are capable,” says Dr. Sarah Andrews, an internist with Utica Park Clinic. “Continuing to be involved in community groups that are directed toward seniors helps promote their emotional well-being. Taking an active approach to health maintenance — getting regular physicals, addressing any concerns early as opposed to waiting until they become severe health issues and getting regular preventive screening — helps at any age, but it especially helps maintain independence as we age.” As your parents get older, it’s important to make sure they are able to take care of themselves so pay attention to their appearance. Do they appear to be taking good care of themselves? Are they safe in their home? Keep an eye out for any signs of problems. Scorched pots could mean they are forgetting about food on the stove. Neglected housework could be a sign of depression. Has your parent fallen recently? Are they able to read directions on medication containers? Driving can become a challenge for older adults. If your parent becomes confused when driving or you are concerned about their safety when driving, it might be time to stop driving. Help your loved one maintain his independence with other transportation options. “As individuals require more assistance, the family members caring for them must determine what help they are capable of contributing to their care,” Dr. Andrews says. “It is OK to admit you cannot give the 24-hour care mom/dad needs and knowing you need to help by bringing outside caregivers into the home or even looking at assistedliving or nursing homes. Even if mom and dad do have to be placed in a nursing home, families need to be actively involved and visit as much as possible. Anytime families stay involved in the care of their aging parents, those parents typically maintain better health and emotional well-being for a longer period of time.” Deciding to move to a retirement community often is a difficult time for older adults because it involves a significant change in lifestyle, yet it can be one of the most positive moves someone can make. It relieves them of the burden of maintaining a house, provides an added level of security and connects them to social activities and friends they can enjoy in the community. “When looking for a community, it is important to find one that feels comfortable and meets the resident’s needs,” says Gwen Stanberry, director of marketing for Covenant
Photospin
Among the many benefits of living in a retirement community are the friendships cultivated and activities enjoyed. Place of Tulsa. “Having the ability to progress to a higher level of care in the same community is something most residents are seeking. This gives residents and their families the comfort of knowing that, in most cases, the residents will be able to stay in the same place and stay involved in the same activity groups as their need levels change. For example, even if residents must move from residential independent living to assisted living, they will still be in their same community and be able to continue to participate in the groups and clubs they have become a part of, with the friends they have made and the staff that know them.” Sometimes residents may show signs of a need for increased care that may not be available in the community where they have been living. For instance, a resident may develop memory care issues. Memory care is a very specialized type of care. Residential communities can develop partnerships with memory care communities that they trust. This allows residents and their family peace of mind in knowing that regardless of the need, residents are getting the best care. “It is important to remember that everyone ages differently, and needs change at different times,” Stanberry says. “Being as flexible and accommodating as possible is
of the utmost importance. Being able to offer assistance and recommendations to the family and having families support the staff offers great advantages to the residents, and they trust that you will always have their best interests at heart.” Whether older adults are able to stay in their homes or choose to move into retirement communities or require more extensive care, it’s vital to take the time now to talk with your aging parents about a variety of issues, including having an advance directive. “It’s important that family members know our wishes in the event we are critically ill,” Dr. Andrews says. “However, as a parent ages, oftentimes we face issues many families have never discussed. Would mom/dad want to be resuscitated? Would they want dialysis or a feeding tube? These are the tough conversations that often are not addressed while parents/family are healthy. If for some unforeseen reason mom and dad are not able to have an active role in this discussion, families are frequently faced with these extremely difficult decisions. Planning for the different levels of senior care starts with talking with your loved ones about expectations, preferences and possibilities. There is no better time to start than now.
Control your blood pressure (Brandpoint) — A routine doctor’s appointment often involves a health professional checking your blood pressure. The screening is not painful or stressful and typically takes less than a minute to measure. However, the results of this simple test may identify a condition that, when managed, could help reduce your chances for stroke or heart attack. High blood pressure may not have any symptoms, but it can cause serious damage to arteries, leading to heart disease and stroke. Nearly one in three adults in the United States has it, and many remain unaware of the condition for years, according to the American Medical Group Foundation (AMGF). A blood pressure screening in a doctor’s office can determine if you have healthy or high blood pressure. Doctors, nurses, pharmacists and other health professionals can recommend lifestyle modifications and/or medicines to control the disease.
Health myths that might surprise you (Brandpoint) — Living a healthy life takes some resolve, but success often comes down to knowing what pays the biggest dividends for a given effort. Health coaches are great sources for this insight. They’ve seen it all on the job and learned a lot in their training. Health coaches for Provant, a workplace well-being company, have identified seven health and wellness myths from their research: Myth No. 1: An aerobic workout boosts your metabolism all day. Wrong, it just burns calories while you’re doing it. Muscle-strengthening exercises, however, will burn calories long after your workout. Myth No. 2: If you don’t break a sweat, it’s not a workout. Wrong, sweat is just the body’s way of cooling itself. A better reflection of effort is the talk test: Your workout is moderate if you can talk, but not sing, and vigorous if you need to take a breath every few words. Myth No. 3: You should stretch before you exercise. Not really, you could hurt yourself. Better to stretch after you’re warmed up with light, smooth movement of gradually increasing intensity. Myth No. 4: Frozen fruits and vegetables are less healthy than fresh ones. Actually, they’re both healthy. Frozen fruits and vegetables are generally picked and frozen at nutritional peak. Canned can be a fine choice if you’re watch-
ing your budget. Avoid fruits packed in syrup. Myth No. 5: Cigars and chewing tobacco are safe because you don’t inhale. This is false. Cigar smokers have higher rates than nonsmokers of death from chronic obstructive pulmonary disease and are four to 10 times more likely to die from cancers of the throat, mouth, lips, larynx and esophagus, according to the American Cancer Society. People who chew tobacco are more likely to develop oral cancers that affect the tongue, lips, cheeks and gums. Myth No. 6: Stress happens, and there’s nothing you can do about it. Not true. Stress doesn’t have to overwhelm you. There are several approaches to managing it. Set priorities and tackle simple problems first. Then move to complex difficulties. Practice relaxation exercises. Make yourself more resilient by eating smart, exercising and avoiding tobacco. Myth No. 7: Cold turkey is the best way to quit tobacco. Nope. It’s just one of the ways to quit, and the more times you try to quit, the better your chances of succeeding. Research indicates that to help improve success rates, you need the desire and readiness to quit, some form of pharmacotherapy (nicotine replacement therapy or prescription medications) and social support (family, friends and health coach). Keep this information in mind as you go about improving your health, and most importantly, don’t give up.
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Commonly asked questions about
chemotherapy
The American Cancer Society estimates that more than 1.6 million cancer cases are expected to be diagnosed in 2014. Unfortunately, that means you probably know someone who will be affected by this disease. And, chances are chemotherapy may be part of that person’s treatment. To help put your mind at ease, Teri Jennings, director of clinical services at Cancer Treatment Centers of America, answers some commonly asked questions about chemotherapy: Where do I go to have chemotherapy treatments? Generally, chemotherapy may be administered on an outpatient basis, but it may also be given as an inpatient basis. Make sure the hospital or facility has accreditations and certifications by independent organizations associated with quality cancer care. For instance, Cancer Treatment Centers of America in Tulsa (CTCA) is accredited by The Joint Commission and recently was awarded a Quality Oncology Practice Initiative (QOPI) Certification by the American Society of Clinical Oncology. The QOPI Certification Program recognizes outpatient hematology-oncology practices that meet the highest standards for quality cancer care. CTCA is the first certified program in the state of Oklahoma.
How long will the treatment take and how is it given? Just as every person is different, so is every treatment. The amount of time for treatment varies. Some facilities, like CTCA, offer chemotherapy 24 hours a day, so a patient can schedule his treatment after work or on the weekends. Chemotherapy may be given in cycles followed by a period of rest. The rest period gives your body a chance to build new healthy cells. Chemotherapy may be given in many ways: • Intravenous — through a vein. • Injection — usually in a muscle or right under the skin. • Intra-arterial — directly into the artery that is feeding the cancer. • Intraperitoneal — into the peritoneal cavity or the area around your mid-section. • Topically — applying a cream onto your skin. • Orally — pills, capsules or liquids are swallowed. It’s important to meet with a member of your care team prior to your chemotherapy regimen so that you have a good understanding of what to expect and to get any questions you have answered. What side effects should I watch for? Fatigue is the most common side effect. Continuing a daily routine of activity may improve how you feel and your energy level. Pace your activities so you don’t overdo it. Plan to accomplish the things that matter most to you. Accept help from your family and friends. They may feel helpless during your treatment, so allowing them to assist with your grocery shopping or house cleaning is a win-win situation for everyone. Nausea is usually the most feared side effect. Your doctor may prescribe a combination of medications to control nausea or stop vomiting before and/or after chemotherapy. At the first sign of nausea, the anti-nausea medicine should be taken as prescribed by your physician. It’s best to keep track of when nausea/vomiting occur and share this with your doctor. Establishing a pattern of eating meals and snacks at the same time each day may help. Some chemotherapy drugs may also cause hair to thin or may result in complete hair loss. Your doctor can write a prescription for a wig, if you prefer this over a hat, scarf, cap, turban or simply leaving your head uncovered. You can even have a wig made before you start losing your hair. A stylist can help you choose a wig and cut that matches your current style. When should I call for help? You need to stay ahead of the game, especially if you are experiencing pain. If your medications aren’t working as you feel they should, notify your care team as soon as you can. Generally, you will have a care manager who is a
Courtesy of Cancer Treatment Centers of America
A nurse prepares a patient for chemotherapy in the Infusion Center at Cancer Treatment Centers of America. nurse that you can call 24 hours a day. How can I maintain a good quality of life during chemotherapy? There are many ways to combat side effects and still have a good quality of life during treatment. Nutritional support, naturopathic medicine, pain management, chiropractic care, mind-body support, spiritual support and rehabilitation are some integrative ways to combat side effects and stay strong enough to fight the cancer. What precautions should I take to stay healthy during chemotherapy?
Chemotherapy can take a toll on your immune system. That’s why it’s important to be proactive in fighting off infections. Hand washing is the first line of defense to keep germs from entering the body. In addition, keeping your fingers away from your eyes, nose and mouth is also important. Remember, your health-care team wants you to fully understand your treatment. If often helps to write questions down prior to your appointments so you will remember all of the ones you want to ask. It may also be helpful to have a caregiver or loved one take notes to capture all the information you may have missed. And, if you are not satisfied with the answers or options, get a second opinion so that you can make an informed decision.
Back-to-school lunch, snack ideas Staying active helps you maintain a healthy life (Brandpoint) — If schools and parents received report cards on the lunches they’re serving kids, most wouldn’t receive a passing score. Many lunches, whether served at school or brought from home, are made with bleached flour, artificial sweeteners, food coloring, high-fructose corn syrup, artificial preservatives, hormones and trans fats. Studies have shown that these ingredients are linked to weight gain, defects in insulin and lipid metabolism, hyperactivity, increased risk of tumors, cancer, digestive issues, asthma, premature heart attacks, diabetes and overexposure and resistance to antibiotics. As a parent, what can you do to keep your child healthy? Life Time - The Healthy Way of Life Co. suggests asking your child’s school where its foods are sourced and the nutritional values and ingredients they contain so you can make informed decisions. “The more highly processed foods are, the more likely they are to contain the seven unsavory ingredients, meaning they are foods it’s best to find alternatives for,” says Laura Burbank, a registered dietitian with the Life Time Foundation. “We encourage parents to speak with school nutrition directors and cafeteria managers about reducing the amount of highly processed and artificial items served in their lunchrooms, in favor of wholesome, real foods, and we’re able to help parents throughout that process,” Burbank says. Until changes are made, Burbank advises actively engaging kids — starting when they’re young — in packing lunch at home. “Getting kids involved in packing their
lunches makes them more likely to eat and enjoy them,” says Burbank. “They feel helpful, and they’re learning along the way.” She says it’s important to include a protein, whole grains, fresh fruit, vegetables and healthy fats with every meal. She offersw these ideas: Lunchbox option No. 1: • Lunch: turkey or ham sandwich with avocado and spinach on whole grain bread. Look for meat that is free of hormones, antibiotics, nitrates, artificial preservatives and other additives. • Snack: orange slices and string cheese. Lunchbox option No. 2: • Lunch: grilled chicken breast, avocado and roasted bell pepper or shredded carrots in a whole grain pita with a Greek yogurt-based dressing or pesto. • Snack: apple slices and almond butter. If your child’s school has a strict nut-free lunchroom guideline, include Greek yogurt with vanilla and/ or honey. Lunchbox option No. 3: • Lunch: a wholesome PB&J made with almond butter and 100 percent fruit preserves on whole grain bread. • Snack: hard-boiled eggs, cherry tomatoes, cucumbers with Greek yogurt-based vegetable dipping sauce or pita chips and peppers with hummus. Healthier lunchroom choices If making lunch at home isn’t an option, parents can discuss healthy lunchroom options with their kids, as studies have shown that in addition to nutritional benefits, healthier diets also associate with higher academic performance.
Be active for at least two and one-half hours a week. Include activities that raise your breathing and heart rates and that strengthen your muscles. Help kids and teens be active for at least one hour a day. Physical activity helps to: • Maintain weight.
• Reduce high blood pressure. • Reduce risk for type 2 diabetes, heart attack, stroke and several forms of cancer. • Reduce arthritis pain and associated disability. • Reduce risk for osteoporosis and falls. • Reduce symptoms of depression and anxiety.
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Menu revisions add fresh, healthy options GYPSY COFFEE HOUSE 303 MLK Jr. Blvd. 918-295-2181 Food: ••• Atmosphere: •••• Service: order at counter (on a scale of 0 to 4 stars) 9 a.m. to 10 p.m. Monday, 9 a.m. to 11 p.m. Tuesday-Thursday, 9 a.m. to 2 a.m. Friday, 10 a.m. to 2 a.m. Saturday and 10 a.m. to 10 p.m. Sunday; accepts all major credit cards; gluten-free, vegetarian, vegan available.
Second helpings Restaurant Critic Scott Cherry
tulsaworld.com/tabletalk
hummus topped with mixed greens, red onion, three of the best-looking tomato slices we’ve seen this year and sliced avocado, then drizzled with balsamic vinaigrette. The Turkey Twister is one The Gypsy, at 15 years old, of the signature items. It was is one of the longest-running piled high with sliced turkey, businesses in the Brady melted Swiss cheese, mixed Arts District and has always greens, tomato and onion on has been known for its teas a buttery croissant. I chose (14 specialty tea drinks, Dijon mustard over mayo 30 bagged teas) and coffee to give the sandwich a little drinks. attitude. Manager Mary Whitfield, The scones and cake were who joined the staff a year pretty as pictures. One scone ago, recently completed a was full of juicy, plump second revision of the food blueberries and was topped menu, “probably the biggest with a light lemon icing. The changes that have been made other was a bit sweeter, filled in years.” with raspberries and white “I’ve added more options, chocolate chips. Both were like the flatbreads and soups, more moist than most scones and taken into consideration we have encountered, and more dietary restrictions, both were great with hot tea. like having gluten-free opA cocoa cake was topped tions,” she said. “All of our with blueberry-blackberrysandwiches can be served as cream cheese icing dotted lettuce wraps, and that apwith fresh blueberries. It was peals to gluten-free customdense and flavorful without ers and people who just don’t being overly sweet. eat bread.” All of the food presentaWe do eat bread, modertions were thoughtful, and ately of course, and ordered the portions generous. It the garden flatbread ($6.75), should be noted that no alcothe Turkey Twister sandwich hol is served at the Gypsy. ($7), a couple of scones ($2 and $2.25) and a piece of The garden flatbread at Gypsy Coffee House has a layer of hummus cake ($3). topped with mixed greens, tomato slices, red onion and avocado slices, The crispy flatbread then drizzled with balsamic vinaigrette. STEPHEN PINGRY/Tulsa World started with a layer of earthy
Man wants to change his monogamous dating procedure Dear Amy: I am a 32-year-old male. I have been in a string of monogamous relationships for the past 18 years, the shortest of which was one year and the longest, ending in divorce two years ago, was 8½ years. All of my relationships (5 in total) were back to back — no courting period, zero to 60 really fast. I am at a point in my life where I am figuring out what I need to do for myself. I am ecstatic to say that I am truly happy on my own and have real self-confidence. I now feel ready to enter the dating world. I want to do it right and, for once, be choosy. I do not know how to navigate and have no idea what it means to see more than one person. What is the etiquette for dating multiple people? Is this implied and understood? Does that only change when there is a frank talk about exclusivity? Is it expected to be exclusive when things get physical? I know that it will vary to some degree depending on the opposing party, but I am looking more for what is ethical. I am still not 100 percent comfortable with seeing more than one person, as it is against my instincts to some extent given my history, but I know it is best for me. — Nervous Dear Nervous: If you are not comfortable seeing more than one person at a time, then don’t. If you are a serial monogamist, then you will be in good company — many people prefer this. The big, huge, obvious thing you need to do differently this time, versus the previous five relationships you’ve had, is to take it slowly. No more zero to 60. Dating can be wonderful, but if you are launching yourself into relationships at first meeting, then you are not dating, you’re flinging yourself toward your next breakup. It will be very good for you to be more in control of the pace of a relationship. Dating is ideally a process of gradual discovery. If you aren’t getting sexual and attached on the first meeting but are getting to know people first, then you can pursue other relationships casually and ethically. You should expect to move toward exclusivity when things get physical, but talk frankly with any potential partners to see if they are on the same page. You will find
Ask Amy Amy Dickinson askamy@tribune.com
that some people want to leap right in, but remember — this doesn’t work for you. Dear Amy: I work in a small office at my church. I like my job a lot and would like to stay there. Another person who has worked here much longer than I have makes inappropriate remarks and racist jokes. I’ve made disapproving remarks, ignored the comments and walked out of the room. Today she came out with yet another racist comment she thought was witty. I am so uncomfortable around her that I interact with her as little as possible and say as little as possible, especially if there is any chance the conversation would elicit an offensive comment from her. I’m considering going to the pastor, but if I do it will cause a huge rift among staff and the congregation, and I’ll likely end up having to leave a job I otherwise really like and need. What can I do? — Working in Purgatory Dear Purgatory: First, you should state to this coworker, “Really, please stop making these offensive comments. None of this is funny, so please stop.” Then you must speak with your pastor. Be prepared with specific examples. Your pastor should handle this as a confidential workplace and pastoral matter, not as a confrontation within the congregation. Dear Amy: I couldn’t believe your boneheaded response to “Distressed in Dallas,” the college student whose mother investigated all her boyfriends. If more parents did this, fewer girls would end up abducted and murdered. — Disgusted Dear Disgusted: I am not aware of a rash of crimes against college students by dates who could otherwise have been stopped by intrusive parents. Young people must be empowered to develop their own good judgment. You can contact Amy Dickinson via email: askamy@tribune.com. You can also follow her on Twitter @askingamy or “like” her on Facebook.
This platter features pastor, chicken, shrimp and asada tacos served with refried beans and rice. MICHAEL WYKE/Tulsa World
LOS ALTOS 7990 E. 41st St. 918-794-7766 Food: ••• Atmosphere: •• Service: order at counter (on a scale of 0 to 4 stars) 11 a.m. to 10 p.m. MondayThursday, 11 a.m. to midnight Friday-Saturday, 10 a.m. to 10 p.m. Sunday; accepts all major credit cards.
Los Altos has 13 basic dishes, including two offered only on the weekends, ranging from $1.25 tacos to an $11.99 carne asada platter. Most can be made with a variety of meats and seafood. For our main dishes we selected a chicken tostada platter ($5.99) and a tinga burrito ($6.50). We also had a side of guacamole (99 cents). The platter held two flat corn tostadas topped with a mound of shredded chicken and refried beans. It was served with rice, beans and a salad of lettuce, lots of onion, tomato, cilantro and
green peppers, which was added to the tostada. The burrito was loaded with tinga — shredded chicken simmered in chipotle sauce — through the middle. The chicken was surrounded by a layer of beans and a line of fresh avocado slices pushed into the beans across the top of the burrito. It had a terrific flavor, and the tinga gave it just a little zing. Tacos are the street taco type, made with corn tortillas, diced onions, fresh cilantro and meat of choice. Meat choices include asada (steak), pollo (chicken), tinga and pastor (spicy pineapple pork). For a small extra charge, diners may select pescado (tilapia), camaron (shrimp) or lengua (roast beef tongue). Instead of complimentary tortilla chips, Los Altos hands out duritos, also known as duros or Mexican wagon wheels. They are light and airy wheat chips that puff up when deep fried.