Caregivers and Seniors Can Find Healthy Holiday Recipes at Mayo Clinic.com

If you are a caregiver preparing holiday meals for seniors who have special needs, you can visit The Mayo Clinic website. Recipes in the Healthy Living section include heart healthy diets, diabetic diets, high fiber diets, low sodium diets, and more. Traditional Thanksgiving recipes that are high in carbohydrates can be redesigned to be healthier.

The Cooking Clinic section has topics such as "Recipe Makeovers: 5 Ways to Create Healthy Recipes, " "Ingredient Substitutions," and "Adjusting the Servings."

For example, instead of traditional gravy there is a recipe for "Roasted Turkey With Balsamic Vinegar Sauce."

Olive oil, rosemary and garlic are used to season the turkey while it's cooking. Instead of the usual gravy recipe you use 1 cup of balsamic vinegar, 1 cup of defatted turkey drippings, and 3 tablespoons of brown sugar.

A 5 ounce serving has 247 calories, 34 grams of protein, only 10 grams of carbohydrates, and 6 grams of fat.

The featured Healthy Living Recipes included such variety as corn tamales with avocado-tomatillo salsa, spicy red lentils, and baked apples with cherries and almonds.

With recipes from the Mayo Clinic caregivers can prepare healthy Thanksgiving and Christmas dinners.

Alzheimer's Sundowning - Things That Can Help

For many years I worked with caregiver agencies, and many of the clients had Alzheimer's Sundowning. I found that the things that helped were unique in each person's case. Below are descriptions of some typical situations and what worked to make things better.

One lady who had sundowning had previously wandered outside, while her husband was napping in the late afternoon. She walked downtown in a tourist area. Passing travelers saw she looked like she needed help and picked her up in their car.

She couldn't remember her name or where she lived, and they drove around for hours trying to see if anything looked familiar to her. Although she had lived in the town for decades, she did not recognize anything. Eventually someone recognized her and was able to guide them to her home.

When her husband became ill and was hospitalized, I arrived as a 24 hour stand-by-assist caregiver for a long row of days. The first afternoon I was there she became more and more agitated. Suddenly she went out the door and walked rapidly toward town, saying she had to catch a train to go home.

I caught up with her and used my cell phone to call someone with a car to come and pick us up. She accepted that I was a friend. She believed she was staying with me for awhile for company. She didn't recognize her own home.

During the next days I got a system going. We spent afternoons playing dominoes, coloring pictures, eating healthy snacks, looking at magazine pictures, doing easy jigsaw puzzles, playing easy card games, doing crossword puzzles and looking at photo albums. I might be doing most of the picture coloring but she picked out the colors. Visual activities worked well, but conversation was difficult because she could not follow it.

For the crosswords I would read the question and we'd make guesses together on the answers. For cards I would lay them out and play both sides but she watched while I explained it. Even if I was doing most of the activity she was still enjoying participating by watching.

When she lost interest I switched to another activity and so on. We put the pictures we colored up with tape. She enjoyed making more pictures with me each day.

If she was participating in an activity it kept her attention busy, so she didn't hop up and start out the door to go wandering when sundowners started in the late afternoon. Watching TV didn't work well because she didn't get involved enough with it.

I also found that having lots of lights on helped. I'm not sure if it made her feel it was earlier in the day, or if she could see better, or if it helped avoid shadows and hallucinations. But, having the house well lit helped.

Being active during the day helped her sleep better at night. We tried going out in the car for scenic drives, going for walks, and going downtown to sit and watch people and activities.

All these things helped pass the time, keep her attention, and provide enough activity, without overdoing it. By night time she was ready to rest.

Too much activity though and exhaustion or stress could make sundowners worse. It had to be a balance that was just right, but since each day is different all I could do was try my best.

Soothing music also helped. Some people liked to listen to soft spiritual music and old favorite hymns, such as "Shall We Gather At the River." Others just seemed more content and calm with any smooth, easy going music that was popular with their age group.

I would try to keep my voice and actions calm and quiet, and just go with the flow. One lady with Alzheimer's Sundowners frequently thought we were in an airport. When I was assisting her as she used her walker to head for the bathroom she would say she hoped we didn't lose her husband in the airport.

She had me tear up pieces of paper and drop them on the floor, so that her husband could follow them to find her. She was so afraid of losing him in the airport. In the morning she knew she was in her own home and recognized us. But by late afternoon Sundowners time she thought she was in an airport.

The people with Alzheimer's Sundowners will not believe you if they don't recognize their own home, but you insist that they are indeed in their home. Just going with the reality they are experiencing instead of arguing is important. Wherever they say they believe they are, that is the location and reality you go along with.

If they don't recognize their home, I've asked them to stay in the house for the night, before returning to their own home tomorrow. Usually in the morning they recognize it as their own, but when late afternoon Sundowners starts then once again they may want "to go home."

At any moment people with Alzheimer's may be completely cognizant. But you cannot make assumptions, because in the next moment that can change. Clear thinking one minute, with good memory recall, can switch to confusion with lack of memory the next minute.

Exhausted Caregivers During the Holidays Are Hidden Heroes

Caregivers often put their heart and soul into taking care of people whom they assist. During the holidays exhaustion and stress, "caregivers' syndrome," may be worse due to the extra rushing around. Preparing for festivities is fun, but it can be tiring. Recently I have had several caregivers speak to me about the added exhaustion and stress they feel at this time of the year.

I wish there was a special award to give to all the caregivers who do so much to make others lives better, and who often go without thanks and praise for all they do. Being a caregiver is very special. It's not a high status or high paying role, but in the world of nonmaterial things and goodness of heart it's at the top.

During the holidays it would be nice to go out of our way to tell caregivers they are special and wonderful. Caregivers who are on "stand by assist," meaning they cannot leave the person they assist alone, give up their own dreams, time for friends, and hobbies, because they care about others.

Isolated and sometimes forgotten, caregivers are the hidden heroes of the world today.

Seniors Can Find Mental Fitness Programs at "Sharp Brains"

Mental Fitness Programs are the specialty of "Sharp Brains." A recent post titled "Mental Fitness: 10 Myths Debunked" starts with the myth that it's "in our genes." The article says there is a 35% to 40% reduced risk of developing Alzheimer's for people who "lead mentally stimulating lives, through education, occupation and liesure activities."

Another myth is that it is costly to improve our cognitive ability. Every time we learn something new we change the structure of the brain. The article explains there is a "modification, growth or pruning of our neurons, connections called synapses." The physical characteristics of the brain change when we learn new skills, concepts or facts.

The article also says another myth is that crossword puzzles are the best way to improve our cognitive skills as we age. Dr. Daniel Gopher, Professor of Human Factors Engineering at Techion Institute of Science says, "Computer based cognitive trainers are the most effective."

Today the number of seniors using computers continues to grow, and the mental stimulation provides a good workout for the brain. I always encourage seniors who are hesitant about using computers to get involved in a learning program as one way to provide fitness training for the brain.

American Diabetes Association Says Plan Ahead to Keep Blood Glucose Levels Down During Holiday Feasting

The American Diabetes Association offers tips for diabetics during the holiday feasting. It is a time when it's easy to stray from the special diet that a diabetic needs. The stress can also contribute to exhaustion, overeating, and changes in blood glucose levels. To prepare for the holidays the American Diabetes Association advises checking your schedules and menus in order to plan ahead.

Just yesterday a friend of mine, who is a 70 year old diabetic, mentioned she had begun celebrating the holidays and her blood suger was way up. When everyone else is partying and eating high carb foods, such as cookies, bread, pizza, cake and pies, it is easy to lose track of what you eat.

The website explains it's important to keep the fat, suger and carbohydrate counts under control in the foods that you prepare for the holidays. Traditional recipes may need to be altered or to use substitutions.

The website for the American Diabetes Association suggests getting plenty of exercise. It is tempting to spend a lot of time sitting and eating when there is so much feasting going on. The site recommends using exercise to help control blood glucose levels.

An article on the site titled "Eat Your Veggies" recommended avoiding potatoes, corn and starchy vegetables as the high carb vegetables can raise blood glucose levels. Tomatoes, carrots, squash, and green vegetables were recommended.

If you are a caregiver for a diabetic you will be preparing holiday foods. By using substitutions in the recipes you can keep the food healthy for a diabetic to consume and enjoy. There is a wealth of information on menu planning at the American Diabetes Association website to help you plan ahead.

Senior Centers Provide Thanksgiving Gatherings - No One Needs to Be Alone During the Holidays

Senior Center gatherings provide holiday social time for people who might otherwise be alone. Holidays can be difficult for seniors who feel isolated. Those who live far away from families or who have lost touch with friends may feel the holiday blues. Senior Centers provide a place for active or frail seniors to gather and share holiday dinners.

An example of the benefits of participating in activities at a senior center is the one where I volunteer, The Central Coast Seniors Center, San Luis Obispo, California.

Close to 100 Thanksgiving Dinners were provided today by the Center, and we shared a time of friendship and family style togetherness. Seniors who live alone, senior couples whose family lives far away, or seniors who live with caregivers were all part of the group, so no one had to be alone or isolated.

Great music was provided by The Music Man, Paul Lassonde, pictured above, who croons classic favorites including country western, cool soft rock, swing, and oldies but goodies.

People who had not attended a senior center gathering before said they didn't realize we were having so much fun there.

The table where I sat had some great humorists, and I spent the dinner laughing as they tried to outdo each other with jokes. People of all ages participated, including one of my 94 year old friends.

If you, or someone whom you assist, would like to join a fun social group you can check your local phone book or the internet listings for senior centers in your area.

Hospital Impact Blog RE: 25% of People in Study Misread Prescription and Appointment Info

Dr. Marc C. Rothman writes at the Hospital Impact blog in a post titled "Healthcare Complexity: The Elephant in the Room" that an article in the Archive of Internal Medicine had details about a study of healthcare literacy. Over a period of 6 years, the authors of the article included 3500 people over the age of 65 in the study. The results were "A quarter of the folks had inadequate healthcare literacy, meaning they misread prescription bottles and appointment slips."

As one can guess this group had a higher chance of dying in the next six years. The difference between the chances of dying were 40% for the group with healthcare literacy difficulty (reading prescriptions and appointments), and ony 18% for those with good healthcare literacy.

Dr. Rothman reports in the blog that the difference was greater in those who had cardiovascular difficulties because these conditions need many "prescriptions, appointments and tests."

This highlights the importance for caregivers to keep a medication log, a daily caregiver notes diary, and a calendar to record test dates, appointments and so on.

Caregivers are non-medical. But if something seems to be puzzling, or you think an elderly person is misreading a prescription or appointment slip, you can contact the appropriate source for help.

A call or appointment with the doctor, nurse, pharmacist, therapist or other healthcare professional can provide information to clarify or explain prescriptions and what they are for. Calling to verify appoinments, and keeping a calendar listing treatments and tests is important.

If, as a caregiver, you have a question, don't hesitate to phone for information to the appropriate source, or point out the situation to a family member and/or healthcare professional who can help.

Hospital Overbilled You? Errors? Medical Claims Advocates Review Hospital Bills

At Medical Claims Advocates you can get ideas for action when there is an error on a medical bill. At CNN Money an article titled "Five Ways to Cut Your Medical Costs" by Cybele Weisser said that errors occur in 80% of medical bills. One of the suggestions the article made is to use a Medical Claims Advocate who can review your medical bills for a percentage of the money saved. A website at the Health Rights Hotline provides Independent Assistance for Health Care Consumers, and has suggestions for when medical billing problems occur or are suspected.

An acquaintance in his mid-seventies told me today about receiving a $600 bill from a hospital this week, for three procedures, with three different dates. He had been given treatments at a hospital after he fell while fishing in a river and cracked his knee. He said he understood the treatments involved an IV drip that lasted for about an hour, and were for the purpose of delivering antibiotics to the knee.

Here are the problems. He only had one of these types of treatments. He understood that his Secure Horizons would be paying for it. He was never near the hospital on two out of the three dates.

Luckily he did not automatically write out a check for $600 to pay the bill and mail it. This morning he went to the hospital business office. After spending the morning there, it was determined that he was correct. He was really only there for the treatments once. There were no other treatments scheduled or expected.

The amounts on the bill for two more treatments could have been a typing error, if someone hit a three instead of a one, but there are two more dates with treatments listed, so a typing error does not seem likely.

The hospital determined that Secure Horizons would now be billed and that he does not personally owe anything.

If he had not scrutinized his bill and gone to the hospital billing office to wait in line, and be an advocate for himself, he would have simply written out a check for $600.

How many other people out there are paying bills that have errors like this? If the hospital actually typed in two more dates and treatments, so this is not just a typing error, what is going on? What can be done to protect seniors from paying bills with errors, or something worse (were the two extra dates typed on purpose?), like this?

I searched on the internet and found the Medical Claims Advocate site. In addition to scrutinizing all of your bills carefully, keeping dates of your treatments to compare to the bills, and going back to ask for explanations, a Medical Claims Advocate can help "screen" the bills for errors.

It's another lesson to be careful before paying medical bills.

Foundation for Alzheimer's and Cultural Memory Has a "Bridge"

A new approach to Alzheimer's quality of life is presented by a documentary titled "There Is a Bridge."The Foundation for Alzheimer's and Cultural Memory says "Everyone, regardless of their degree of mental sharpness, needs companionship, not only to physically survive but also to live emotionally." You can check your local listings for public television to see when it's being shown in your area.

The Chicago Memory Bridge is a project that educates junior high and high school students about Alzheimer's and Dementia and pairs them with seniors who have dementia.

The website at MemoryBridge.org includes useful and interesting resources that provide insight for understanding how to cope with someone who has Alzheimer's. For example, below are a few of the articles there.


"The Human Face of Alzheimer's" is an article there by Colleen Campbell that tells the story of Ronald Reagon's experiences with Alzheimer's.

"Touch, A Fundamental Aspect of Communication with Older People Experiencing Dementia" by Madeline Gleeson and Fiona Timmons explains why touch is so important.


"Celebrating Senior Storytelling" by Gene Mitchell explains using storytelling to use imagination and build relationships.

Alzheimer's Society - More New Evidence Fish and Vegetables Prevent Dementia

Today the BBC News has an article titled "Healthy Diet Cuts Dementia Risk," subtitled "More evidence that a diet rich in oily fish and vegetables can reduce the chances of dementia later in life has been uncovered by scientists."

The Mediterranean Diet has long been known to help protect against dementia. Several new studies showed beta-carotene, which contains anti-oxidents, helps the brain avoid damage.

The article explains a study with 8,000 participants. The ones who ate a diet high in omega-3, an oil found in fish, had a higher percentage of avoiding dementia. People who ate fish once per week had a 40% less chance of dementia during the four years of the study. Eating fruit and vegetables reduced dementia risk by 35%.

Another study followed 4,000 participants for 18 years. Half of the participants who took beta-carotene, the chemical that gives carrots their color. The participants who took beta-carotene scored much higher on mental tests.

National Memory Screening Day Is November 13, 2007 - The First Step Towards Getting Help

National Memory Screening Day is tomorrow, November 13, 2007. Spearheaded by the Alzheimer's Foundation of America, and it is now presented as a shared effort by a group of organizations. If someone you know has any of the warning signs of memory issues this is the chance to get more information. Below are some of the signs listed at the Alzheimer's Foundation of America that it is time for a memory screening.

• Forgetfulness
• Difficulty concentrating
• Difficulty performing tasks
• Difficulty remembering words or names
• Forgetting where you are
• Misplacing things
• Getting lost in a familiar place
• Mood or personality changes

If someone you know has been avoiding getting a memory screening then Nov. 13 provides a good opportunity to get one without actually having to go to the doctor's office. Screenings are held in a variety of locations and health professionals from a number of related careers provide the memory screening.

You can go to the alzfdn.org to look for the locations of memory screening sites. You can also call your local Seniors' Center as they often have this type of information and may well be participating in the screening.

The screening is held in a private setting. Questions or tasks test memory, language, thinking, and other mental skills. The results are confidential.

According to the Alzheimer's Foundation other warning signs of dementia can include the following.

Relying on memory helpers

Depression or irritability

Seeing or hearing things

The site explains that depression, vitamin deficiencies or thyroid problems can also cause memory issues and that after a screening the next step is to see a doctor for further tests.

National Home Care and National Hospice Month is November

November is National Home Care and National Hospice Month, and an article at Medical News Today says that over "7.5 million American's receive daily assistance from nearly one million caregivers." Val Halamandaris, president of the National Association for Home Care and Hospice, says , "Dedicated people spend their days taking care of those who can no longer care for themselves, making them silent heroes who should be recognized and thanked all year round."

The article, dated November 9, 2007, provides tips to help family members know when it's time to get help from Home Care or Hospice.

It also provides questions to ask when choosing a home care provider.

At the home page for the National Association for Home Care and Hospice you will find information on legislation, caregiving, education, and other consumer information.

The opening page has a quote from Mother Theresa, "Yesterday has gone, Tomorrow has not yet come, We have only today, Let us begin."

There are suggestions for ways to celebrate Home Care and Hospice this month, including recognizing the physical and emotional support that dedicated home care workers provide for those who can no longer take care of themselves alone.