Mom, you were right when you always told me to... "eat your fruits and vegetables." Fruits and vegetables are excellent sources of fiber, vitamins, minerals, and antioxidants.  As a bonus, they tend to be low in calories but very filling. Generally, everyone should eat 5 or more fruits and vegetables per day broken down into 2 or more servings of fruit and 3 or more servings of vegetables.

But, let’s face it, the price of fresh fruits and veggies can definitely leave a dent in our wallets.  But,  they are soooooo good for you!  Instead of skipping these nutritional foods, buy produce when it is in season in generally much less expensive.  The list below represents common fruits and vegetables in season during the spring months.

Fruits:
 Apricots
 Bananas
 Honeydew
 Mangoes
 Pineapple
 Strawberries
 
Veggies:
 Asparagus
 Broccoli
 Cabbage
 Collard Greens
 Green Beans
 Lettuce
 Peas
 Onions
 Leeks
 Mushrooms
 Rhubarb
 Spinach

And be sure to check out our Aging Well:  Healthy Choices Solution Center for more nutritional tips and advice to keep you healthy and strong! 

If you were unable to speak for yourself, would your loved ones know your wishes regarding medical care?   

Today marks the 6th annual observance of National Health Care Decisions Day and serves as the perfect time to talk to others about your future healthcare decisions and wishes.   Health Care Decisions Day is designed to raise awareness of the need to plan ahead for healthcare decisions whenever patients are unable to speak for themselves and to encourage the use of Advance Directives to communicate these important healthcare decisions. Advanced health care planning can seem like a daunting and depressing task; however, taking the time now to think about your end of life care options and express your wishes to your loved ones and healthcare professionals can ensure that your preferences are known and will help to prevent future disagreements. 

You can find the current Virginia Advance Directive forms here.   If you have questions or would like more legal advice about Advance Directives, you may wish to contact an attorney that specializes in elder law.  To locate an elder law attorney in your area, visit www.SeniorNavigator.org and type ‘Lawyer’ in the Topic Search box and your Zip Code. 

Take charge of your end of life care and encourage family and friends to do the same.

Do you know what respite services are?  Have you heard about The Virginia Lifespan Respite Voucher Program that launched recently?  If you are a caregiver, be sure to read on as this information is for you.

Respite services provide temporary relief to the caregiver away from the care recipient. These services may be offered in adult day services centers, nursing homes or assisted living facilities. Other types of respite services may be offered in the caregiver's home through home care agencies, area agencies on aging (AAA or "triple-A's") or other organizations. 

Respite services have become part of the continuum of care for care recipients. A continuum of care is a progression of care required by an individual to remain independent in the community. On one end of the continuum is someone who is totally independent in the community. At the other end of the continuum is an individual who is living in a long-term care facility. Respite services provide trained individuals to give the caregiver confidence that the care recipient will be cared for safely in the caregiver's absence. Respite services allow the caregiver a brief period of time away from the dual stresses and strains of providing round-the-clock care and managing their household, job or family life.  Respite services also allow the care recipient to have a break away from the caregiver. It is easy to forget that the care recipient also feels the stresses of being dependent and can benefit from contact with new people or someone with different skills or who is less stressed. Respite is beneficial to everyone.

To defray the cost of such services, The Virginia Lifespan Respite Voucher Program was developed as new program funded through a federal grant awarded to the Virginia Department for Aging and Rehabilitative Services (DARS).  It provides reimbursement vouchers to home-based caregivers for the cost of temporary, short-term respite care provided to individuals of any age with a disability or special need (infants, children and adults, including elderly persons).  Due to limited funds, not all eligible applications will be approved, however.  Visit the DARS website to learn more about The Virginia Lifespan Respite Voucher Program. 

Types of Respite
• In-home Respite Care:  This includes personal care and companion services, and takes place in the care recipient's home. These services are offered by private for-profit, private not-for-profit, and local government agencies. Local Departments of Social Services, through their Adult Services programs, may offer companion or homemaker services for people who are homebound. Many area agencies on aging also provide short-term personal care in the home on a sliding fee basis. Trained volunteers often are companions for respite services. In other cases, professional care services are offered to help with the bathing, transferring and toileting.
• Adult Day Services:  These facilities may care for any adult over the age of 18 with a physical or mental impairment. Generally a high proportion of participants are functionally dependent and many have cognitive impairments. This environment is very good for the care recipient because of the social interaction and it also gives the care recipient a break from the routine of the home environment. Some caregivers find it difficult to get the care recipient up and ready for adult day care. Others find that extra effort well worth it to have the day and the home to themselves. Adult day services staff generally provide useful tips about getting the person ready and will also help arrange transportation. Once the routine of going is established, most caregivers and care recipients benefit from the regular access to professional staff, the activities and the contact with other families that adult day care provides.
• Institutional Respite Care:  Nursing homes, assisted living and occasionally hospitals provide respite services for those care recipients who may need to be away from their home overnight or for several days. They are also able to handle the individual who is in need of greater care. The cost and completion of the paper work in this type of facility discourages the use of them.

Things to Think About
Before deciding on what kind and how much respite care you need, give some thought to your situation. Ask yourself these questions:
• Which tasks do I need help with? (companion services, home care services that would help me with ADLs, transportation)
• Do I need someone to sit with my care recipient?
• Do I need help around my home? (yardwork, home repair, cleaning, shopping, fixing meals)
• Which tasks does my care recipient need help with while I am gone?
• Is there a family member that will help me?
• Do I have any limitations on what I can afford?
• Am I eligible to receive any respite services?
• Has my doctor written a referral for these services? Can my doctor recommend a facility which provides respite?
• Have I checked with the Area Agency on Agency? Do they have any scholarships available?
• Are there national organizations that may provide respite support? (ie. American Cancer Society, Alzheimer's Association)
• Does my church have volunteers that can help me?
• Would my care recipient benefit from going to an Adult Day Care Center?

Cost
Costs for respite services vary depending on the level of care that is required and the type of facility where it occurs. Institutional Respite care will usually be the most expensive followed by in-home Respite Care, with Adult Day Care being least expensive.
 

Under the Medicare Hospice Benefit, short-term in-patient respite care is covered. Medicare will cover 5% of the Medicare payment amount for inpatient respite care. You can stay up to 5 days at a time at a Medicare approved hospital or nursing home. There is no limit on the number of times that you may get respite care. The amount you pay for respite care can change each year.

Medicaid does cover respite in an adult day services center if the care recipient meets income requirements and is dependent in the activities of daily living (include bathing, toileting, eating, etc.). Medicaid also covers short-term in-patient respite care under the Hospice Medicaid reimbursement. Medicaid will cover respite services to relieve family members or other persons caring for a hospice patient at home. Medicaid will not cover respite services for hospice patients residing in a nursing home.

Caregiver Tips
• Planning for regular respite is part of taking care of yourself. It is easier to arrange regular respite and prevent caregiver burnout than to find reliable care after you are worn out or in crisis.
• When using respite services that are located away from home, such as adult day services or overnight respite, try to take along a few things that are familiar to the person in your care. Some caregivers have told us that they take along pictures, a favorite pillow or a favorite blanket because these things help keep a sense of calm and security.
• Keeping a notebook with information about the person in your care can make caregiving easier for you.

Be sure to visit www.SeniorNavigator.org to locate respite services in your area. 

We all know that making good food choices is key to our everyday health and how we feel as we get older.  You may be eating plenty of food, but not eating the right foods that give your body the nutrients you need to be healthy.  With healthful eating habits, you may reduce your risk of many chronic diseases such as heart disease, diabetes, osteoporosis, and certain cancers, and increase your chances for a longer life.

According to the US Department of Health and Human Services, a healthy eating plan is one that:
• Emphasizes fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products.
• Includes lean meats, poultry, fish, beans, eggs, and nuts.
• Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars.

Try these tips:
• Shop smart: At the store, plan ahead by buying a variety of nutrient-rich foods for meals and snacks throughout the week.
• Lose the fat: In a restaurant, opt for steamed, grilled, or broiled dishes instead of those that are fried or sauteed.
• Lunch wisely: When grabbing lunch, have a sandwich on whole-grain bread and choose low-fat/fat-free milk, water, or other drinks without added sugars.
• Pack snacks: On a long commute or shopping trip, pack some fresh fruit, cut-up vegetables, string cheese sticks, or a handful of unsalted nuts-to help you avoid impulsive, less healthful snack choices.  Mix up your choices within each food group.
• Focus on fruits: Eat a variety of fruits-whether fresh, frozen, canned, or dried-rather than fruit juice for most of your fruit choices. For a 2,000- calorie diet, you will need 2 cups of fruit each day (for example, 1 small banana, 1 large orange, and 1/4 cup of dried apricots or peaches).
• Vary your veggies: Eat more dark green veggies, such as broccoli, kale, and other dark leafy greens; orange veggies, such as carrots, sweet potatoes, pumpkin, and winter squash; and beans and peas, such as pinto beans, kidney beans, black beans, garbanzo beans, split peas, and lentils.
• Get your calcium-rich foods: Get 3 cups of low- fat or fat-free milk-or an equivalent amount of low-fat yogurt and/or low-fat cheese (11/2 ounces of cheese equals 1 cup of milk)-every day. For kids aged 2 to 8, it's 2 cups of milk. If you don't or can't consume milk, choose lactose-free milk products and/or calcium fortified foods and beverages.
• Make half your grains whole: Eat at least 3 ounces of whole-grain cereals, breads, crackers, rice, or pasta every day. One ounce is about 1 slice of bread, 1 cup of breakfast cereal, or 1/2 cup of cooked rice or pasta. Look to see that grains such as wheat, rice, oats, or corn are referred to as 'whole' in the list of ingredients.
• Go lean with protein: Choose lean meats and poultry. Bake it, broil it, or grill it. And vary your protein choices-with more fish, beans, peas, nuts, and seeds.
• Know the limits on fats, salt, and sugars: Read the Nutrition Facts label on foods. Look for foods low in saturated fats and trans fats. Choose and prepare foods and beverages with little salt (sodium) and/or added sugars (caloric sweeteners).

And, hey, if you find yourself having a snack attack, don’t reach for that cookie or bag of chips.  Instead, reach out and view more nutritional information and interactive tools found in SeniorNavigator’s Aging Well: Healthy Choices Solution Center. 

Ahhhhhh, Spring!  Flowers blooming, birds singing, warmer temperatures... and springtime colds?  Born and raised in Virginia, I certainly know all about our springtime weather;  one day snow; the next in the 70s.  With the ever-changing springtime weather, it's important to keep your immune system strong.  As your body’s defense against illness, (yes, even that dreaded springtime cold!) here are 3 tips to follow to help your immune system stay in tip-top condition so you can enjoy all of the loveliness that Spring has to offer:

• Eat a well-balanced diet
• Get  your Zzzzzz’s (sleeping 7-9 hours a night is optimal)
• Exercise (at least 30 minutes a day)
  

There are a wide variety of programs and services available to help older adults and their caregivers.  However, in my travels, I often hear from folks “I didn’t even know there was a service like that available”. Check out this listing of the top 10 most frequently searched topics on SeniorNavigator.  You may just come across a service you or your loved one needs and you didn’t even know was available. 

 
1. Transportation
2. Assisted Living Facilities
3. Caregiver Support
4. Home Health Care
5. Alzheimer's Disease Support
6. Housing Options
7. Meals
8. In-home Help
9. Respite Programs
10. Financial Help

For a comprehensive list of programs and services, visit our Resource Locator – an easy-to-use tool that provides guidance as to the services that best fit an individual’s needs. 

Ladies and gentlemen, it's sad, but true. Yet another scam has surfaced -- this this time around the new Affordable Care Act's medical cards.   The Federal Trade Commission reports that a variation on an old scam is making the rounds. It sounds something like this:

<Ring, ring>

Unsuspecting person who answers the phone:  "Hello?"

Scammer who is calling:  "Ma’am, I’m calling from the government. We’re about to send out national medical cards for the new Affordable Care Act. You’re one of the lucky people to get yours first, so I just need to confirm your name, address and phone number.  Oh, and your bank account number, too…"

This kind of scam pops up any time there’s a big change in a government policy, or when a topic is in the news. Scammers use people’s uncertainty to try to get them to reveal personal information. From there, it’s not much of a leap to identity theft, with scammers racking up bogus charges on your credit cards, opening new credit cards in your name, even taking out loans in your name.

You can protect yourself. If you get a call asking for your information, hang up. It’s a scam. Government organizations and the legitimate groups you do business with have the information they need. They’ll never call to ask you for it.  If you get a call like this, report it to the Federal Trade Commission. The phone number on your caller ID – if there is one – or the name or location of the caller – is helpful information to investigators and professional fraud fighters. You can report it online or on the phone, toll-free, at 1-877-FTC-HELP.  Your report might help stop the scammers, and it could help keep others from being scammed.

Source:  Federal Trade Commission 

The thought of moving -- particularily for an older adult -- can be overwhelming and, frankly, daunting.  If you are you considering moving an out-of-state older relative to Virginia to be closer to you, you are certainly not alone.  Many older adults move closer to their children in later life, whether it is for direct care help, assistance with transportation for errands, groceries and medical appointments, or just companionship and peace of mind for all. But, before any big decision, there are often things to consider and prepare for...a move is certainly one of them.   

With added special considerations for older adults, here are a few items to consider.  Afterall, being prepared is sure to make you and your loved one feel that much more comfortable and confident in your decision. 

1. Medical Insurance. While Medicare transfers between states, not all other insurances (Medicare supplemental, Medicare Advantage programs) are offered in each state. Notify all insurance companies of an impending move far enough in advance to have time for decisions. If the insurance transfers, the transfer is fairly easy, and if it does not you will need to explore options for what is offered and need ample time to do so. For Medicaid recipients, check with your local Department of Social Services.

2. Health Care Professionals. It is advised to do your research prior to moving a loved one and have appointments lined up to immediately establish new health care professionals and avoid any gaps in care. Also, depending on the family member’s health, many older adults can experience moving/transfer shock as a result of a move and can experience medical issues as a result that need to be addressed. Communicate the intent to move to all current doctors in order to get necessary records transferred prior to the move to the new doctors. In some cases, it may be advisable for the current physician to write a letter along with the medical records to aid in the continuity of care.

3. Legal/Financial Advice. Seek the advice of a lawyer and financial planner regarding options for moving. These include reviewing any legal documents (wills, advance directives, etc.) to ensure they are in compliance with the new states regulations. This could also be advice on selling the primary residence.

4. Government offices. Notifications need to be given to Medicare, Social Security, Veterans Affairs, and Social Services.

5. Banking. As with every move, it is best to establish new bank accounts in Virginia before totally closing bank accounts in the former state. It can take up to two-three months to get pensions, social security, stock dividends, etc. transferred to a new bank account, as well as any automatic withdrawals for insurance, RX plans, etc. For some of these companies, they just require a phone call to change the information, and for others they will require a form to be filled out with the new banking information.

6. Area Agencies on Aging (AAA). Your local AAA is a wonderful organization to help you with any transition. Whatever the circumstances, they can support your family through a variety of programs they have to offer or make recommendations to their partnering agencies. For example, if you are in need of advice on new insurances, they have a insurance counseling program (VICAP) to help, there is an ombudsman program that can assist with recommendations on assisted living and nursing facilities, etc., and they have home-delivered meal programs, caregiver support groups, transportation, senior centers, respite care programs, etc. to assist if relocating to her own apartment or even your home. Many services have no or little cost to them since they are subsidized by federal and state funding, while other services are on a sliding-scale ability to pay.

In the meantime, contact the Area Agency on Aging that services the area in state where the loved one resides. If you believe she needs any services until a move occurs, or if you need assistance with an assessment as to what level of care may be appropriate when she moves, the Area Agencies on Aging can coordinate with one another.

7. Opportunity for the Veterans Affairs Aid and Attendance Benefit. If the older adult served during any wartime period, or is the widow of a wartime veteran, there is a little-known benefit from the Veteran Affairs that is available to help offset the costs associated with activities of daily living - whether that is in a nursing facility / assisted living / or in their own home or apartment. This is not unique to Virginia, so if qualified could potentially be something that would transfer with them wherever they move. Learn more about this benefit via this link.

8. Relocation Specialists. There are a variety of companies that service older clients who are downsizing their homes, or relocating to another state to be closer to their children. Some of the companies have national franchises that work together with the family in both states to ensure a smooth move - auctioning items not desired to move, planning the layout of the new home, and coordinating the move itself, etc. A variety of services to consider depending on the family support available. Depending on the level of need with direct care and management of other aspects of the move that does need to be completed by the family member, this is one that can be handled by an outside source to ease the transition, and also provide some professional guidance.

9. Legal considerations. Whether it is Advance Care Directives, Wills, Estate business, etc., laws vary between states as far as legal documents are concerned. Some state laws are fairly loose compared to Virginia. If your family member has not already completed some of these documents in their current state, you may want to weigh the options of getting them done immediately versus getting them completed soon after arriving in Virginia in order to not have twice the legal costs of having them done. If they have not been completed, or are considerably outdated, you could always seek the advice of a lawyer in the current state, indicating that move to Virginia could be in the near future in order to incorporate any additional language into the documents.

10. Prepaid Cremation and Prepaid Burial Plots. For many people, they do not think about these items. Check into the specifics if your family member has already prepaid for these items in their current state to see if the policy can be either be refunded or transferred if desired to Virginia. For burial plots, decisions will need to be made as to the loved ones wishes whether they would want to be transported back for burial, and in that case, the additional costs need to be understood. If the answer is no, they do not wish to return to their prior state, most cemeteries do not buy back plots. Many people either try to sell them or end up donating the plots to a local non-profit hospice and using the market value established by the cemetery as a tax write-off.

11. Handbook for long-distance caregivers. In the meantime, while you are still deciding on a transition, you may wish to download a very helpful publication for people who are caring for a loved on long distance.

Best wishes in your decision-making.  Remember, SeniorNavigator is here to help make this journey a little easier for you!

Are you on track with your New Year’s Resolution to achieve a healthy weight in 2013?  February is often the time when folks start getting lax on their healthy resolutions.  And with our media reporting rapid weight loss solutions, it is natural for everyone to want to lose it quickly and see immediate results.  But, I am sure it will come as no surprise to you that evidence shows that people who lose weight gradually and steadily are more successful at keeping weight off. 

Did you know that in 2011, 29% of Virginians over the age of 65 self-reported themselves as obese.  Both young and more mature folks can reap significant health benefits be achieving a healthy weight.  The CDC suggests 5 steps as you get started on your journey to lose weight. 

Step 1: Make a commitment.

Step 2: Take stock of where you are.

Step 3: Set realistic goals.

Step 4: Identify resources for information and support.

Step 5: Continually "check in" with yourself to monitor your progress.

Also, have you visited SeniorNavigator's Aging Well:  Healthy Choices Solution Center?  If not, please do.  It’s a great way to help you make healthy lifestyle choices at any stage of your life and keep you on track!