Holiday Tips for People With Diabetes

November is National Diabetes Month. Is it ironic or intentional that this recognition should fall at the beginning of the holiday season, when temptations abound, and travel disrupts our care routine?

The Centers for Disease Control and Prevention (CDC) says that having diabetes shouldn’t stop you from enjoying holiday celebrations and travel. With some planning and a little work, you can stay healthy on the road and at holiday gatherings with friends and family.

The most important step in managing diabetes during holiday travel and festivities is preparing. Know what you’ll be eating, how to enjoy a few traditional favorites while sticking with a healthy meal plan and how to pack necessary supplies for a trip, and you’re all set to celebrate!

At Feasts and Parties

Before you show up at the Thanksgiving feast, take these steps to make sure you stick to your meal plan:

• Eat a healthy snack beforehand to avoid overeating at the party.
• Ask what food will be served, so you can see how it fits into your meal plan.
• Bring a nutritious snack or dish for yourself and others.

You don’t have to give up all of your holiday favorites if you make healthy choices and limit portion sizes. At a party or holiday gathering, follow these tips to avoid overeating and to choose healthy foods:

• If you’re at a buffet, fix your plate and move to another room away from the food, if possible.
• Choose smaller portions.
• Choose low-calorie drinks such as sparkling water, unsweetened tea or diet beverages. If your doctor says it’s okay for you to consume alcoholic beverages, limit it to one drink a day for women, two for men, and drink only with a meal.
• Watch out for special holiday main dishes such as ham coated with a honey glaze, or turkey swimming in gravy. Instead, choose turkey without gravy (and trim off the skin) or other lean meats.
• Select side dishes and vegetables that are light on butter, dressing, sour cream and other extra fats and sugars. (At Thanksgiving, that usually means avoiding the sweet potatoes with marshmallows, and that famous green bean casserole!)
• Watch the salt. Some holiday favorites are made with prepared foods high in sodium. Choose fresh or frozen vegetables that are low in sodium.
• Select fruit instead of pies, cakes and other desserts high in fat, cholesterol and sugar.
• Focus on friends, family and activities instead of food. Take a walk after a meal, or join in the dancing at a party.

Traveling for the Holidays

“Over the river and through the woods….” Or, more likely, to the airport or on the highway. Either way, visiting friends and family means changing routines. Make sure you remember to take care of your diabetes while traveling. Check your blood glucose (sugar) more often than usual, because a changing schedule can affect levels.

Managing Your Medication

• Pack twice the amount of diabetes supplies you expect to need, in case of travel delays.
• Keep snacks and glucose gel or tablets with you in case your blood glucose drops.
• Make sure you keep your medical insurance card and emergency phone numbers handy, including your doctor’s name and phone number.
• Carry medical identification that says you have diabetes.
• Keep time zone changes in mind so you’ll know when to take medication.
• If you use insulin, make sure you also pack a glucagon emergency kit.
• Keep your insulin cool by packing it in an insulated bag.

On the Road and in the Air

• Get an influenza vaccination before traveling, unless your medical provider instructs otherwise. Get the flu shot, not the nasal spray.
• Bring a few bottles of water instead of sweetened soda or juice.
• Pack dried fruit, nuts and seeds as snacks. Since these foods can be high in calories, measure out small portions (¼ cup) in advance.
• The TSA says, “Passengers who have insulin pumps can be screened using imaging technology, metal detector, or a thorough pat-down. A passenger can request to be screened by pat-down in lieu of imaging technology. Screening can be conducted without disconnecting from the pump. However, it is important to let the officer know about the pump before the screening process begins.”
• Place all your diabetes supplies in your carry-on luggage. Keep medications and snacks at your seat for easy access. Don’t store them in overhead bins.
• Have all syringes and insulin-delivery systems (including vials of insulin) clearly marked with the pharmaceutical preprinted label that identifies the medications. Keep them in the original pharmacy-labeled packaging.
• If a meal will be served during your flight, call ahead for a diabetic, low-fat or low-cholesterol meal. Wait until your food is about to be served before you take your insulin.
• If the airline doesn’t offer a meal, bring a nutritious meal yourself. Make sure to pack snacks in case of flight delays.
• When drawing up your dose of insulin, don’t inject air into the bottle (the air on your plane will probably be pressurized).

Don’t Forget to Exercise

It’s tempting to settle in on the couch after those big holiday meals, but this is a bad time to neglect your physical activity routine! How about catching up on the year’s news with a friend or relative while enjoying a walk through the autumn leaves?

Walking is also a great stress-buster—something we can surely be thankful for during the holidays!

Should Seniors Mix Medications and Martinis?

Many people enjoy a cocktail at the end of the day, a beer after exercise, or a glass of wine with dinner. For the most part, moderate drinking is harmless, and might even offer some health benefits. But sometimes, imbibing is unwise and even dangerous.

What does age have to do with it? We know drinking is bad for teens. Their grandparents, too, should think about their drinking. As we grow older, our bodies can’t process alcohol as efficiently, so we feel the effects more. Most people know that alcohol can damage the liver; as we grow older, drinking is increasingly associated with heart disease, certain cancers, diabetes and depression. And it’s no surprise that drinking raises the risk of car crashes and falls.

And in September 2016, researchers from University of Florida released the results of a study showing that the older we are, the more alcohol affects our thinking and memory. Said professor Adam Woods, “As people get older, their decline of memory is one of their greatest complaints. We found that in those who drink heavily, as they age, they have a greater decline in thinking and memory than their nondrinking or moderate-drinking counterparts.” Woods said seniors who are currently, or even were formerly, heavy drinkers have “poorer global cognitive function, learning, memory and motor function,” as well as decreased attention span.

Add to this the fact that most older adults take prescription and over-the-counter medications. Medication management is a challenge for seniors—not only because they take so many different drugs, but also, just as is the case with alcohol, older bodies break down these substances differently. Many medications can have side effects; combining medications raises the risk considerably. Add alcohol to the mix, and seniors are far more likely to experience side effects such as drowsiness, nausea, headaches, fainting, falling, internal bleeding and other stomach problems. Alcohol may even make certain medications less effective.

Yet many older adults are unaware of this problem. The National Institutes of Health recently reported that almost half of all seniors who drink alcohol also take medications that could interact negatively with these alcoholic beverages. These include prescription and nonprescription drugs, and even certain herbal remedies. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that these drugs include:

• Aspirin
• Acetaminophen
• Cold and allergy medicines
• Cough syrup
• Sleeping pills
• Pain medications
• Anxiety or depression medicine

How can seniors avoid a dangerous combination of medications and alcohol?

• Learn about the possible side effects of your medications.
• Read the label of your medications, both prescription and nonprescription, to see if it’s not advised to drink alcohol while taking the drug.
• Ask your doctor or pharmacist if it’s safe to drink alcohol while taking your medications.
• Remember that alcohol and medications can interact harmfully even if taken at different times.
• If you think you might be drinking too much, talk to your doctor.
• Never drink and drive. Period.

Visit the website of the National Institute on Alcohol Abuse and Alcoholism to find a comprehensive list of medications that may interact negatively with alcoholhttp://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm, including a list of side effects seniors may notice.

Source: IlluminAge AgeWise, with materials from the National Institute on Alcohol Abuse and Alcoholism

Top Ten Ways to Protect Your Brain

As we grow older, we tend to worry about our memory and thinking. We hear so much about Alzheimer’s disease and other dementia, and chances are we have friends and loved ones who have been touched by one of these conditions. Some people even believe that memory loss is inevitable—that they will surely become “senile” in their later years.

This couldn’t be farther from the truth for most of us. Sharpness of memory varies from individual to individual. Genes are a factor—by some accounts, about 30 percent of our memory health is hereditary. But the other two-thirds of memory wellness might well be within our control, say experts. There are steps we can take to maintain a healthy memory.

1. Exercise your mind and memory. Mental stimulation encourages new connections between brain cells. “Use it or lose it” isn’t just a cliché when it comes to memory health. Brain experts tell us to give our brains a workout with challenging activities. Learning something new is especially good. Take up an instrument, learn a foreign language, join a club, volunteer, do a difficult puzzle each day. Passive activities, such as watching TV, don’t offer the same benefits. You can also “exercise” your memory using visualization and concentration. And memory aids—from sticky notes to smartphone reminders—can pick up where our memory leaves off.
2. Exercise your body, too! Aerobic exercise has been found to ward off Alzheimer’s disease, stroke and other memory-damaging conditions. It helps us avoid obesity, which is also bad for brain health. Recent research also shows that muscle-strengthening exercise helps the brain. And relaxation exercises, such as tai chi and yoga, are also showing promise. Talk to your healthcare provider about an exercise program that is right for you.
3. Take care of your all-around health. The more we know about cognitive wellness, the more we realize that brain health can be negatively impacted by heart disease, diabetes, high cholesterol, high blood pressure, kidney disease and a number of other disorders. Follow your healthcare provider’s instructions. And ask for a review of your medications; recent studies implicate certain drugs in raising the risk of dementia.
4. Eat a brain-healthy diet.  We can choose foods that help protect memory. Avoid cholesterol, saturated fats and trans fats. Instead, choose fish, fruits, vegetables, and healthy fats such as olive oil. Take a multivitamin if your healthcare provider recommends it—but don’t take megadoses that could be toxic.
5. Quit smoking and limit alcohol consumption. Many substances found in cigarette smoke damage the brain and impair memory. And while some studies suggest drinking in moderation might actually be beneficial, having more than a drink or two per day can be toxic to the brain.
6. Get enough sleep and seek treatment for sleep disorders. You’ve probably noticed that when you don’t get enough good quality sleep, it is harder to concentrate the next day. And did you know that while we’re sleeping, our brain is busy converting short-term memories into those that are retained? Neurologists also tell us that harmful waste material is cleansed from our brain as we sleep.
7. Lower your stress level and seek help for depression. Stress and depression cause chemical changes in the brain that can be so severe that a person’s family or physician mistakenly suspects Alzheimer’s or other dementia—and in addition, they do raise the risk of Alzheimer’s. Talk with your healthcare provider if you feel stressed or depressed. Counseling, meditation and other relaxation techniques can all help.
8. Protect against head injury. A lot of people who worry about Alzheimer’s disease forget that head injuries are another major cause of memory loss. A head injury can result in catastrophic damage to the brain and memory. Always use your seatbelt, and if you are a cyclist, wear a helmet. And protect against falls—especially at home, where most serious fall injuries take place.
9. Have your hearing checked. Studies suggest that older adults with moderate to severe hearing loss may be at higher risk of developing dementia. This may be due to the stressfulness of social isolation, and also to the “exhaustion of cognitive reserve”—our brains have to work much harder when we can’t hear. Hearing loss is often preventable, and hearing aids and other technologies can help seniors improve their hearing.
10. Have regular dental checkups. Tooth loss and gum disease make it harder to eat a healthy diet, and can be a factor in social isolation. And experts now believe that the bacteria and inflammation caused by gum disease and linked to dementia. Talk to your dentist if arthritis or other problems make it hard to care for your teeth and gums.

If you’re experiencing memory lapses, or if you just find yourself fretting about memory problems, share your concerns with your doctor. Stress can really work a number on our memory—so stressing out about our memory is an ironic cycle we want to avoid! Then you can relax, knowing you’re doing everything you can to keep your memory strong.

October is National Physical Therapy Month

National Physical Therapy Month is celebrated every year to honor the many ways that physical therapy helps people improve their mobility, decrease pain and live a healthier lifestyle.

Sponsored by the American Physical Therapy Association (APTA), this event focuses on a particular aspect of physical therapy each year. The 2016 theme is #ChoosePT, calling attention to APTA’s new campaign promoting physical therapy as a superior alternative to medication for pain management.

This topic is very timely! America is in the midst of an epidemic of opioid drug misuse. It affects people of every age, including an increasingly large number of older adults.

Here is a recent statement from APTA on the role of physical therapy in limiting the opioid epidemic:

Physical therapy is one of the non-opioid alternatives recommended by the Centers for Disease Control and Prevention (CDC) in recently released guidelines that urge prescribers to reduce the use of opioids for most long-term pain management. The guidelines indicate that while prescription opioids are appropriate in certain cases (such as cancer treatment, palliative care, and end-of-life care), non-opioid approaches are preferred, given the damaging potential side effects of opioids, which include depression, overdose, and addiction, plus withdrawal symptoms when stopping use.

APTA’s #ChoosePT campaign and the CDC guidelines come at a time when increasing numbers of Americans, no matter what their economic class, are being touched by the opioid epidemic, which includes misuse of prescription opioids and heroin. According to the CDC, the rate of overdose deaths involving opioids has nearly quadrupled since 1999, and in 2012 enough opioid prescriptions were written for “every American adult to have their own bottle of pills.” The #ChoosePT campaign is meant to remind patients that non-opioid pain management options exist, and that they have a choice when it comes to their care.

“Opioids come with numerous serious side effects and only mask the sensation of pain,” explained APTA member and #ChoosePT campaign spokesperson Joseph Brence, PT, DPT. By contrast, physical therapists treat pain through movement. They also play a key role in the crucial patient education process, including setting realistic expectations for recovery. “Research shows that physical therapist treatment can reduce or eliminate the need for opioids by improving physical function, increasing range of motion, and decreasing pain,” said Brence.

Physical therapists treat patients of all ages and physical abilities, and the CDC guidelines point out that “high quality evidence” supports exercise as part of a physical therapy treatment plan for the treatment of low back pain, hip or knee osteoarthritis, and fibromyalgia—conditions that affect millions of Americans. According to the CDC, 25.3 million adults suffer from daily (chronic) pain.

Source: The American Physical Therapy Association (www.apta.org), adapted by IlluminAge AgeWise. Visit www.moveforwardpt.com to learn more about the use of physical therapy for pain relief.

Don’t Fall for “Disaster Fraud”

Steve saw Mom at her computer with her credit card out. “What are you doing?” he asked. Mom had a sad look on her face. “I’m making a donation to a charity that’s helping the Christians who are being persecuted by ISIS,” she said. Steve looked at the email Mom had received; the sender had a Gmail account and the poorly written appeal for money linked out to a CNN news report on YouTube. “Mom, this is a scam,” said Steve. “But I want to help!” said Mom.

This year, Americans have given millions to those affected by the terrible flooding in Louisiana, fires in California, earthquakes in Ecuador, the shootings in Orlando, and the plight of refugees in war-torn countries.  When we hear about a natural disaster or humanitarian crisis, Americans can be very generous in their efforts to help, responding quickly by opening our hearts—and our wallets.

But the U.S. Department of Justice (DOJ) and the Federal Bureau of Investigation (FBI) warn that generous people—many of them seniors—may be victimized by crooks who take advantage of their good intentions to bilk them out of money that goes not to those who need it, but right into the scammers’ pockets.

These crooks might impersonate a real aid agency, or create a bogus organization. The might call you on the phone, come to the door, or send an appeal letter. Today they’re more likely to approach victims by email, or to spread an appeal for money via Facebook. They create a sense of urgency that can trick us into letting our guard down.

In 2015, responding to widespread fraud in the wake of Hurricane Katrina, the Department of Justice joined with more than 20 federal agencies to form the National Center for Disaster Fraud (NCFD). NCFD experts warn consumers to follow the following guidelines before making a donation of any kind:

1. Do not respond to any unsolicited (spam) incoming e-mails, including by clicking links contained within those messages, because they may contain computer viruses.
2. Be cautious of individuals representing themselves as victims or officials asking for donations via e-mail or social networking sites.
3. Beware of organizations with copycat names similar to but not exactly the same as those of reputable charities.
4. Rather than following a purported link to a website, verify the existence and legitimacy of nonprofit organizations by using Internet-based resources.
5. Be cautious of e-mails that claim to show pictures of the disaster areas in attached files, because those files may contain viruses. Only open attachments from known senders.
6. To ensure that contributions are received and used for intended purposes, make donations directly to known organizations rather than relying on others to make the donation on your behalf.
7. Do not be pressured into making contributions; reputable charities do not use coercive tactics.
8. Do not give your personal or financial information to anyone who solicits contributions. Providing such information may compromise your identity and make you vulnerable to identity theft.
9. Avoid cash donations if possible. Pay by debit or credit card or write a check directly to the charity. Do not make checks payable to individuals.
10. Legitimate charities do not normally solicit donations via money transfer services.
11. Most legitimate charities maintain websites ending in .org rather than .com.

Suspected fraudulent activity can be reported to the NCDF hotline at 866-720-5721; report internet fraud to the FBI’s Internet Crime Complain Center (www.ic3.gov).

Steve went over the above points with his mom, and helped her use the Federal Trade Commission’s Charity Checklist to find reputable organizations to which she might donate—while also encouraging her to budget carefully before making charitable donations of any kind.

Know the Signs of Malnutrition in Older Adults

September 26 – 29 is Malnutrition Awareness Week

For older adults with chronic conditions, proper nutrition is more than just a good idea. It’s an essential part of managing many health problems like diabetes, heart disease, high blood pressure, osteoporosis, and more.

That’s why the National Council on Aging (NCOA) encourages all older adults and their caregivers to take time during Malnutrition Awareness Week to learn the warning signs of malnutrition and connect with resources to stay healthy.

“Too often, older adults with chronic conditions can become malnourished because they lose their appetite, or it’s difficult for them to shop for and prepare healthy food,” said Cora Plass, Senior Director of NCOA’s Center for Healthy Aging. “It’s important to understand what malnutrition looks like and take steps to get the nourishment our bodies need.”

The NCOA urges families to be aware of risk factors for malnutrition, such as chewing and swallowing difficulties and taking multiple medications, and to alert their loved one’s healthcare professional if they notice warning signs of malnutrition, such as eating poorly and unplanned weight loss.

The Gerontological Society of America confirms the challenges of good nutrition for older adults and their caregivers. In an online survey of over 1,000 people conducted by Harris Interactive in July 2015, 83 percent of patients and caregivers said they think malnutrition is a significant problem for older adults, yet only 28 percent of caregivers said they understand malnutrition very well. More than 90 percent of caregivers said they provide care for an older adult who has experienced a chronic health problem.

For seniors living with chronic conditions, malnutrition can result in the loss of muscle and other tissue, which can make it harder to recover, increase the risk for infection and falls, decrease strength, and lead to longer hospital stays.

NCOA has teamed with the Families and Work Institute and Abbott to raise awareness about malnutrition in older adults and provide practical information and tips. Free, trusted information is available at www.ncoa.org/NutritionTools.

Source: The National Council on Aging (NCOA), a respected national leader and trusted partner to help people aged 60+ meet the challenges of aging, whose mission is to improve the lives of millions of older adults, especially those who are struggling. Through innovative community programs and services, online help, and advocacy, NCOA is partnering with nonprofit organizations, government, and business to improve the health and economic security of 10 million older adults by 2020. Learn more at www.ncoa.org.

September 18 is National HIV/AIDS and Aging Awareness Day

Established in 2008 by The AIDS Institute, National HIV/AIDS and Aging Awareness Day is an opportunity to dispel the myth that HIV/AIDS is a disease exclusive to younger people. It is an opportunity to encourage older adults to be tested for the virus, and to learn how to avoid contracting or spreading it.

According to the Centers for Disease Control and Prevention (CDC), 25 percent of people in the U.S. who are living with HIV/AIDS are older than 55. Close to 20 percent of newly diagnosed cases are in older adults. They also are more likely to be diagnosed later in the course of the disease, making treatment more challenging.

Some seniors, thinking they are not at risk, know very little about HIV/AIDS. They should know the basics: HIV (human immunodeficiency virus) weakens the immune system, which puts an infected person in danger of getting other life-threatening diseases, infections and cancers. The virus is spread by unprotected sex with, sharing needles with, or coming into contact with the blood of a person who carries the virus. If the body can no longer fight off these diseases and infections, HIV can lead to AIDS (acquired immunodeficiency syndrome), a more serious illness. Not everyone with HIV will get AIDS.

Seniors are at high risk of HIV/AIDS for several reasons. They may be less aware of the disease and how to protect themselves. For example, after years of a monogamous marriage, they might be widowed and dating again, unaware that they should take precautions to avoid infection. Women who no longer worry about pregnancy are less likely to use a condom—yet age-associated physical changes make their bodies more susceptible to transmission of the virus. Seniors are also less likely to talk frankly with their doctor about sexual health or drug use.

Despite being at high risk, seniors are less likely to be tested for the disease. Often doctors fail to recommend testing for older patients—and older patients may be too embarrassed to ask for a test. Seniors who notice symptoms that are associated with HIV, such as weight loss, pneumonia, fatigue, confusion or vision problems, might chalk up these symptoms to the normal aches and pains of aging, or to other health conditions they’re already living with. And they might hide their concerns, fearing the reaction of loved ones and caregivers—both to their diagnosis, and to the behaviors through which they contracted the infection.

The U.S. Administration for Community Living (formerly the Administration on Aging) recommends that older men who have sex with men be tested at least once a year; women should be tested whenever they have a new sex partner. The National Institute on Aging (NIA) says that people who had a blood transfusion between 1978 and 1985 may also be at risk. The cost of the test is covered by Medicare.

People of every age can prevent the spread of HIV/AIDS. The NIA says seniors should practice the following steps to lower the risk:

• If you are having sex, talk with your partner about HIV/AIDS. Know his/her sexual and drug history and make sure your partner has been tested and is free of HIV.
• Use male or female condoms (latex or polyurethane) during sexual intercourse.
• Do not share needles or any other equipment used to inject drugs.
• Get tested if you or your partner has had an operation or blood transfusion in a developing country at any time.
• Get tested if you or your partner had a blood transfusion between 1978 and 1985.

Aging with HIV/AIDS

Many older adults are diagnosed with HIV/AIDS each year, and many others have been living with the disease for a long time. Though there is no cure for HIV, it can be managed with antiretroviral therapy (ART), drugs that allow many infected individuals to live a long and healthy life. Experts say these senior patients face a special set of health challenges:

They may be living with other health conditions that complicate their treatment.

• HIV causes chronic inflammation, which increases the risk of a number of age-related diseases, such as heart disease, osteoporosis, diabetes, cognitive problems and certain cancers.
• Seniors with HIV, more than younger adults, may be affected by the stigma, putting them at risk for isolation, loneliness and depression.
• Expecting to have their lives cut short, many seniors who have been living with HIV for a long time failed to save for their retirement, or make other plans for the extra years they weren’t expecting to have.

Early diagnosis  raises the possibility that older adults with HIV/AIDS can continue to live independently with the disease, and to access support services that they need.

Learn More

The AIDS Institute (www.theaidsinstitute.org)  sponsors National HIV/AIDS and Aging Awareness Day (www.nhaad.org) and offers information and resources for older adults with or at risk of HIV/AIDS.

AIDS.gov is the U.S. government portal for information about HIV/AIDS, including information for older adults.

The National Institute of Aging offers a concise, readable online brochure with an overview about HIV/AIDS for seniors and caregivers.

Find a testing location through your local health department, the AIDS.gov test locator (https://locator.aids.gov), or the Centers for Disease Control and Prevention toll-free at 1-800-232-4636 or gettested.cdc.gov.