But not every senior needs that kind of help. Statistics further show that, overall, the aging population is in pretty good shape.

“We find that the older people get, even if they are in fine shape, the less-inclined they are to leave the house,” explained David Howe, LCSW and director of the Older Adults Mental Health Program at Connecticut’s Bridgeport Hospital, part of its REACH Program (Resources for Adult and Child Mental Health) “Especially men who have lost their spouses. We see a big problem with alcoholism among older men who are isolated and depressed and have nothing but time on their hands.”

Hospitals across the country have myriad services for seniors, including adult day care, counseling services, support groups and companion services.

“The REACH program is really geared to provide a community for seniors, but also a link to other services that they might need,” said Howe.

While the aging population is forcing the door of new options to be opened, those in the various professions providing those options agree that doing your homework early, before crisis hits, is the best way to go.

“What is so hard for the public is that their first exposure to the system is when there is a crisis in the family. It seems no one has planned for it, and all of a sudden, they enter this new world, and are forced to get a crash course,” Fatone said.

Resources
State and local listings may vary for services for the aging, but every state has Visiting Nurses Associations that can provide links to outreach programs in the area. Most local hospitals have adult day care programs and provide counseling and assistance services for seniors as well. Here are some toll-free numbers to get you started:

Eldercare Locator was established in 1991 and can link you with the information and referral networks of state and local area agencies on aging. Trained staff are on duty from 9 a.m. to 11 p.m. ET to help answer questions. Contact (800) 677-1116.
The American Association of Retired Persons (AARP) provides comprehensive information on the aging population. Contact (800) 424-3401 or www.aarp.org for more information. AARP also sponsors a chat line on AOL on Wednesdays.
The Visiting Nurses Associations of America, Boston, Mass. Although each of the VNAs are independently run, this central trade association represents more than 200 across the country and can provide links. Please contact (888) 866-8773.
Gray Panthers is an advocacy and educational organization working for social change by addressing issues such as national healthcare, job social security, housing, sustainable environment, education, and peace. A joint effort of the National Institute on Aging and the Administration on Aging, Gray Panthers has local chapters.

Tips
Getting an early jump on taking care of an aging relative or friend is the number one tip from those in the industry. This means doing some research into what’s out there in the way of resources and covering most if the bases, even if they seem premature.

“Most nursing homes have waiting lists, and the only way you can bypass that is if you are private pay or in dire medical need,” explained Toni Fatone, executive vice president of the Connecticut Association of Healthcare Facilities (CAHF). “Even if you don’t know if you’ll ever need one, it is very smart to research which nursing home is your top choice, fill out the paperwork and get on the waiting list. Once you are on the list, you are on there forever and you can retain that spot when and if you need it.”

“At least 25 percent or one in four of our residents will need to stay at a nursing home at least once, whether it’s a brief stay or longer,” added

Bill White, who owns and operates three assisted living facilities in Connecticut. “Nursing homes have a definite place in the care of our aging population.”

Understanding what is covered under Medicare and whether or not Medicaid is an option is also part of the process.

“Medicare kicks in at 65 regardless of income,” said Fatone. “But it’s important to understand how the system works, and what exactly is covered.”

Since there are limits and guidelines as to what is covered, looking into long term care insurance is another preemptive measure.

“I would highly recommend finding a policy that allows for coverage of home care and assisted living, as well as nursing home care,” said White. “Because for the price of one year in an assisted living facility for which you will have to pay out of pocket, you could probably buy a lot of premiums.”

For 55-year old Ron Correnti, one of Christine Correnti’s three children, the decision was the best one to make for his independent mother, following his father’s rapid decline battling Alzheimer’s, which forced them to put him in a nursing home.

“It got to be too much for her, to travel to the nursing home every day, living alone in that big house which has always been a lot of work to keep up,” he said.

The Correntis are not alone. As America continues to gray, decisions about how to care for parents and aging relatives, and eventually ourselves, begin to inch their way forward on the priority list of life. “As we look at the demographics, the elderly population is like a tidal wave ready to crash,” said Toni Fatone, executive vice president of the Connecticut Association of Healthcare Facilities (CAHF), which represents 160 of the 250 nursing homes in the state. The association is also an affiliate of the American Health Care Association, which represents 11,000 of the approximate 19,000 nursing homes nationwide. “The average age of a nursing home resident is 85,” Fatone added.

And statistics released by the Administration on Aging in Washington, D.C., indicate that the fastest growing age bracket is exactly that age: 85 years and up.

“What happens is that people don’t really think about it until there is a crisis,” Fatone said. “Maybe mother or father is in the hospital and needs to be discharged to a nursing home. All of a sudden they have to find a nursing home, and there’s no guarantee that they’ll get into their first, second or even third choice.”

Across the country, nursing homes compile waiting lists for patients in varying degrees of need. In Connecticut, for instance, the occupancy rate is at 98 percent, in part because of a 1991 legislature-imposed moratorium on the development of new nursing homes aimed at stemming burgeoning Medicaid costs. While nursing homes are almost at full capacity, assisted living facilities are also seeing an increase in demand nationwide.

“It’s an excellent option. The average age of our typical resident is 83,” said Bill White, president of The Bridges, which owns, runs and operates three assisted living facilities — or 340 units — in Connecticut. Nationwide, there are about 1.5 million units. “We provide an independent environment in an apartment situation. Food, linen, housekeeping and even a social life is provided.”

The difference between the two types of facilities has to do with the level of care needed, or the health status of the resident: Nursing homes are traditionally for much more acute care and assistance with the tasks of daily living, while assisted living facilities have a focus on residential living and are not considered healthcare institutions.

“Typically, assisted living is about 50 to 60 percent the cost of a nursing home,” said White, who is also the New England representative to the National Center for Assisted Living. “In Connecticut, that would translate into $3,000 versus $6,000.”

Unlike nursing homes, however, assisted living facilities are not covered by Medicare or Medicaid. Many of the facilities, even if they have onsite healthcare, which is required in Connecticut and other states, have arrangements with home care agencies to provide needed support and assistance. While there are more than 30,000 profit and nonprofit home care agencies nationwide, they are facing some problems of their own: a national nursing shortage, changes in Medicare reimbursement and a tight labor pool.

Question: Our family room is 22′ x 16′ but has no storage in it. I plan to use the room for homeschooling and home daycare and am trying to think of a way to create inexpensive, yet attractive storage. One more thing…the room has a sloped ceiling — it’s about two feet higher at one end of the room than at the other.

Answer: Your family room appears to be large enough to consider creating two separate “living” areas within the room. You mentioned homeschooling and daycare needs; these would be continuous activities within your family room. Why not arrange your furniture so that all of the child/school activities are together on one side and your storage needs are on the other side?

Consider setting up the school/daycare area with toy boxes, bright plastic cubes and low shelving that little hands can reach. Place several large comfy floor pillows in the same space. Perhaps adding a sofa and television for “rest” time would be a good idea. Decorate the space with framed artwork from your children. Large cork boards can be used for your homeschooling lessons, as well as your children’s creations. I would tend to place this area on the side of the room with the sloped ceiling, as the children are less likely to hit their heads (being shorter than adults).

Your other “living” space can be set up as a family room/study. You can purchase “do-it-yourself” shelving units relatively inexpensively from your home improvement centers, where the shelving is adjustable to fit your needs. If you want to dress up the plain shelving, think about purchasing several large, shallow wicker baskets and placing them inside your shelving compartments. (The baskets can also be spray painted to coordinate with your room’s color scheme.)

Arrange the furniture in this area as a vignette; perhaps try two oversized chairs (or recliners) with a small table and floor lamp between. You can create your own “library” by separating the two areas with either bookshelves, a sofa, or a folding screen.

Good luck with your room!

A house development as kitchen remodel project it’s a great, successful way to improve cost of home moreover upgrade place that your family use and see all day.

two to three centimeters of vagina with the cervix.

The surgical procedure itself takes approximately two to five hours depending on multiple surgical factors. Occasionally, it requires blood transfusion because of blood loss. Hospitalization is usually two to five days, again depending on the length of surgery and the health of the patient.

Follow-up usually involves care of the bladder and many practitioners leave a catheter in the bladder for it to heal as much as possible. This often takes up to three weeks.

External radiation therapy, with an implant, may also be a part of the treatment process. Radiation therapy and surgical therapy for early stage disease have approximately the same cure rates, and depending on their medical condition, almost all early-stage patients are offered either choice.

The chief disadvantages to radiation therapy are the large number of treatments necessary, the need for a radiation implant and the long-term scarring effects of radiation. Although for early-stage disease these are minimal, patients who receive radiation therapy have a certain amount of scarring for life, and in rare circumstances, may have enough scarring to require additional surgery and medical therapy. Finally, for many young patients, the disadvantage of radiation therapy is that it always destroys ovarian function.

There is controversy over whether patients with more advanced stage IB cancers should have surgery, followed by specimen analysis and then radiation therapy, or whether they should initially have chemo-radiation therapy, with or without subsequent hysterectomy.

Patients who are given these choices, who have been told they have a relatively advanced disease confined to the cervix, should always participate in this decision-making process. If possible, these patients should be considered for treatment under scientific protocols, or clinical trials, which are rigidly controlled studies of new treatments, to see if they are safe and effective.

These trials may offer patients a chance to benefit from improved treatment methods. The trials are almost always of benefit to patients who have this problem later.

The patient with advanced early-stage disease should seek a second opinion from another gynecologic oncologist if there is any doubt that the treatment plan fits her expectation of what is best for her. The names of gynecologic oncologists can be obtained by calling the Society of

In many situations, treatment at a medical center is necessary, as there are only approximately 600 board-certified gynecologic oncologists in the United States and these are usually concentrated in major medical centers. Gynecologic oncologists in private practice often use the services of more than one hospital. Whether the actual treatment is performed in a medical center will depend on several factors, but the treatment should be under the direction of a board-certified gynecologic oncologist.

Stage IA — In selective circumstances, surgical conization may be adequate treatment for microinvasive disease of the cervix. However, patients are almost always treated with a surgical procedure to remove the cancer, uterus and cervix (total abdominal hysterectomy). The ovaries may also be taken out, usually in older women (bilateral salpingo-oophorectomy).

Stage IB — For tumors with deeper invasion, surgery to remove the cancer, uterine ligaments, cervix and part of the vagina (radical hysterectomy) along with the lymph nodes in the pelvic area (lymph node dissection) is performed.
Radical hysterectomy has been performed for approximately 100 years, since Dr. John Clark at Johns Hopkins Hospital in Baltimore performed the first procedure.

In a radical hysterectomy the ligaments surrounding the cervix, for about three centimeters, are removed with the cervix. Additionally, lymph nodes in the pelvis, and usually around the lower part of the aorta, are removed to look for signs of metastatic spread.

Technically, this procedure involves removing the ureter from its location and the ligaments supporting the uterus. (This requires special training that is the backbone of the training of the gynecologic oncologist performing this intricate surgical procedure.)

A radical hysterectomy also involves removal of the back foundation and some of the nerves leading to the bladder in order to obtain an adequate surgical margin. This may lead to a slight degree of bladder dysfunction; for example, some women may not experience the sensation that they need to void. However, with rare exception, bladder function is significantly altered only temporarily.

Patients selected for radical hysterectomy have the option of preserving their ovaries. Cervical cancer in its early stages rarely metastasizes to the ovaries.

When cervical cancer occurs in women who still have ovarian function, ovary preservation is one of the chief advantages of surgical treatment. The additional advantage of surgical treatment is the removal of the cancerous organ, a process that can be emotionally satisfying to many patients.

Voisine had to learn to walk again after the surgery and was advised not to run or jump for a year. On a positive note, she was two inches taller after doctors fused her spine with metal bars and a bone graft from her hip.

The recovery period was long and frustrating. However, a decade later, she’s pleased with her decision. Her top curve is about 32 degrees and the bottom is about 21 degrees, but the former track team member has great posture and ran a marathon in March.

She has had a few bouts of pain and expects her back to age quicker than it might have without scoliosis and surgery, but she says she believes the experience lead her to a healthier lifestyle.

“My back felt fine during the marathon,” she said. “In retrospect, I’m so glad I did it. At this point, I have no regrets.”

Judy

A.Autoimmune diseases are not typically thought of as infectious, but there are some cases when they may be. Long before birth, the immune system begins to develop. This disease-fighting system has to do battle with all the different infectious agents that it may encounter. To do this, immune system cells learn to distinguish different substances, mainly proteins. The immune response obviously is not perfect, given that death from infections can still occur, but it is adept at fighting most of the viruses and bacteria we encounter.

A.Antibodies are one of the immune system’s major infection-fighting tools. These remarkable proteins recognize distinct chemical structures called epitopes (usually portions of proteins) on viruses and bacteria. When the immune system encounters a new pathogen (disease-causing microbe), white blood cells called B cells produce antibodies directed against specific epitopes on the organism. These antibodies also interact with other cells, including white blood cells called T cells and a group of chemicals called the complement system, to help eradicate the threat. T cells, as well as natural killer cells, macrophages and other immune cells, can also act independently of antibodies to attack some pathogens.

How does the immune system distinguish the proteins that are pathogenic from those that are “self” and therefore should be left alone? In a very complex manner, each person develops tolerance to his or her own proteins and cells. This is why a person’s immune system does not attack his or her own blood cells, but it does quickly destroy transfused blood cells that are the wrong blood type.

A.As with any organ system, however, the immune system can become defective. Sometimes antibodies are formed that do attack “self” proteins — that is, proteins that are normal constituents of the body. In fact, there are probably always very small numbers of antibodies against self, but their activity does not cause any significant effect. But when antibodies and even cells with activity against self are present in significant numbers, an autoimmune disease can develop. The number you mentioned — 24 — seems like too low a number for all the autoimmune diseases that have been described, and I think it is pointless to try to name all of them.

Many of these diseases — such as lupus, rheumatoid arthritis, Sjogren’s syndrome and scleroderma — can cause joint problems. Several others, such as Goodpasture syndrome and Wegener’s disease, can cause kidney damage. Infectious diseases are thought to trigger some, if not most, autoimmune diseases. Rheumatic fever, caused by strep bacteria, occurs when antibodies that form to fight the strep also act on cells in the heart and joints. Certain forms of encephalitis can be triggered indirectly by viruses and even vaccines (such as the old rabies vaccine, which is no longer in use). Some investigators believe that multiple sclerosis develops in this same.

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Lunch
Lentil or black bean soup
Sourdough bread with margarine
Raw baby carrots
Granola bar (check label to avoid milk or egg ingredients)

Snack
Fruit smoothie made with 1/2 cup soymilk,
Frozen banana and 1/2 cup strawberries

Dinner
Meatloaf made from textured vegetable protein and topped with barbeque sauce. Roasted red potatoes (roast with sprinkle of olive oil and rosemary)

Garden salad with balsamic vinaigrette dressing

Raspberry sorbet
1 cup fortified soy milk
Snack
5 whole grain crackers
1-2 tbsp peanut butter
Fresh fruit juice mixed with seltzer

It’s customary to see advertising for various medications in medical journals. But I remember the first time I saw an ad for Seldane, the first nasal decongestant that didn’t cause drowsiness, in a woman’s magazine and then on television. It listed the symptoms of a typical allergy sufferer, and then told the viewer to “ask your doctor.” The name of the drug was then put on the screen. It was very effective, and Seldane sales reflected the success of the advertising blitz.

The most recent ad I heard on the radio was for an anti-viral medication used in the treatment of genital herpes. It hinted that by taking the medication every day, a sufferer could decrease the severity and number of outbreaks.

This new and direct line that the pharmaceutical companies have taken has fascinated me and troubled me somewhat. I’m fascinated because the ads are smart, direct, and obviously are making a difference in product sales. But I am also troubled, because with this approach the doctor and nurse are circumvented. Sometimes that’s OK, but many times it is not.

There have been times when a patient has come in with a complaint like difficulty breathing and has asked for a nasal decongestant by name because she saw it on television. But if the examination shows that the inside of the nose is crooked or the nasal lining is just dry, a decongestant would be a waste of money. Or consider the person with herpes who is persuaded to take a medication every day, when outbreaks only happen two to three times a year. Many doctors would agree that prescribing an anti-viral medication to be taken every day is overkill in this situation.

I certainly am not saying that patients should be left in the dark as to what is available for certain ailments. To the contrary, I believe that patients should be well informed and active participants in their health care.

However, keep in mind that nothing is as important as a talk with your doctor and a good physical examination before anything is prescribed.

With the maturing of the mighty baby-boomer market and the growing necessity to reduce the cost of preventable chronic diseases, a more sophisticated and wary market is putting a higher premium on professionalism in fitness services.

There’s a difference of opinion in the industry about whether providers of fitness services ought to become professionals in the legal sense, with strict licensing codes. But, I have not heard anyone argue out loud that managements and staffs of fitness facilities should not act professionally.

The oldest use of the word “profession” (literally a “public declaration”) was in the Middle Ages, as clergymen put themselves on record as being servants of God. Soon, doctors, lawyers and teachers took on professional status, promising to observe codes of ethics and practice. By the early 20th century, accountants, nurses, engineers, dentists, architects and others formed recognized professions.

Beyond the licensed professions, the word “professional” has been used more loosely — even to indicate someone who plays for money at a game that others play for enjoyment. While money has always seemed to come more easily to people in the professions than to the common folk, that does not seem to me to be the heart of professionalism.

The “virtual professional” (VP) has all the “virtues” of the professional without having to be recognized by a formal body. The key virtue is to put the client’s wellbeing ahead of any personal gain. To support that virtue, the VP is committed to constantly improve their knowledge and skill. The VP conducts his or her activity with the pride and integrity of the pure professional. In quality of performance and ethical standards, the VP does not cut corners. The VP’s sense of vocation and enthusiasm results in the customer’s sensing that the VP cares about their comfort, enjoyment and physical wellbeing.

Money seems to follow professionalism. But hard-sell tactics that make money the first object are corrosive of professionalism, not to mention customer satisfaction and loyalty. If you have read this far, you are not one of the quick-buck operators who are giving the industry a major black eye. You envision your club as professional, but how do you provide sales incentives without getting your sales people more focussed on numbers than on people? The club is only as professional as the front-line people (some major clubs have done away with sales staffs altogether; everyone who deals with clients both serves and softly sells).

Willie Sutton was said to have robbed banks because “that’s where the money is.” Though widely quoted, Sutton told a biographer he never said it. He robbed banks “because I enjoyed it.” Now that’s a professional bank robber!

To extend virtual professionalism throughout your organization, support an atmosphere where staff can enjoy doing, and are prepared to do, what’s right for the customer and ultimately what’s right for the company. Make sure the short-term dash for the numbers does not lead your staff to cut corners on virtual professionalism.

There’re numerous strong and great benefits of first aid kits. The medications that are affordable at an internet drugstore are normally much more economical than which are available in a nearest pharmaceutical establishment.