Men: Are you taking care of yourself?

仲の良い父と娘Happy Father’s Day to all men who play a caring role in the life of a child, and kudos for  all that you do. But let me ask you this: Do you take care of yourself? Typically, most men take better care of their cars than themselves. Most men wait until a symptom pops up, and by then the illness or disease has progressed.

I’m not going to give you a lecture about how you should make an appointment tomorrow to get a routine preventative check-up, but hopefully after going through the following list, you’ll see my point.

Take this quiz to see how much you really know about men’s health. 

1) As a man gets older, it’s almost inevitable that he:

  1. loses interest in sex
  2. has a difficult time maintaining an erection
  3. doesn’t need to exercise as much
  4. develops an enlarged prostate

2) To detect prostate cancer early, a man should:

  1. have a colonoscopy
  2. practice a monthly self prostate examination
  3. have a digital rectal exam and PSA blood test
  4. have a sonogram of his prostate every year

3) Impotence can result from:

  1. drinking too much alcohol
  2. recreational drug use (smoking marijuana)
  3. high blood pressure
  4. diabetes
  5. all of the above

4) 75% of prostate cancer occurs in:

  1. Hispanic men
  2. men over 65
  3. men who eat a low-fat diet
  4. men with low testosterone levels

5) The most common cancer among men is:

  1. prostate cancer
  2. lung cancer
  3. skin cancer
  4. colon cancer

6) Which racial/ethnic group is most likely to develop prostate cancer?

  1. Caucasian
  2. Asian
  3. Hispanic
  4. African-American

7) A common risk factor for developing prostate cancer is:

  1. lack of exercise
  2. high fat diet
  3. high testosterone levels
  4. growing older
  5. all of the above

8) What beverage has been found to support prostate health?

  1. beer
  2. green tea
  3. orange juice
  4. red wine

9) What common food has been found to support prostate health?

  1. oranges
  2. tomatoes
  3. beef
  4. cheese

10) Which disease is considered the number one cause of death among American males?

  1. diabetes
  2. prostate cancer
  3. obesity
  4. cardiovascular disease

11) Cardiovascular disease kills far more men and women than cancer.

  1. True
  2. False

12) Eating a diet that includes plenty of pasta, potatoes and white rice can reduce your risk of heart disease.

  1. True
  2. False

13) The heart muscle is totally responsible for maintaining normal blood pressure levels.

  1. True
  2. False

14) Cardiovascular disease is hereditary and cannot be prevented.

  1. True
  2. False

15) CVD starts in the teenage years.

  1. True
  2. False

16) An aspirin a day is the best way to thin the blood, in order to reduce the chance of stroke and heart attack.

  1. True
  2. False

17) High blood cholesterol is the best overall indicator of cardiovascular disease.

  1. True
  2. False

18) Statistics show that the stress of caregiving can result in chronic disease for the caregiver and take as many as ten years off one’s life.


Answers:

1) d

2) g

3) e- all of the above. Not smoking, eating a healthy diet, not overdoing it when it comes to drinking, regular exercise, getting enough sleep, will all help support normal blood flow. Also, Ginkgo biloba extract helps support normal blood flow to the penis

4) b. Simply growing older increases a man’s risk. Seventy-five percent of prostate cancer occurs in men over 65 with only 7% diagnosed in men under 60 years of age.

5) c. Skin cancer is the number one form of cancer in the US. Prostate cancer is the most common cancer among men next to skin cancer and the second leading cause of cancer death in men after lung cancer.

6) d. African-American males have the highest incidence of prostate cancer, a third higher than white males, and African-American males are also twice as likely to die from it.

7) e. Also, men who have higher testosterone levels, or who eat a high fat diet have been shown to have an increased risk of developing prostate cancer.

8) b. Green tea is chock full of antioxidants that have been shown to reduce cancer. Red wine, on the other hand, is a natural preventative against cardiovascular disease.

9) b. Tomatoes contain lycopene, especially potent in the fight against prostate cancer.

10) d. Among major disease groups, heart disease is the leading cause of death within the elderly population.

11) True. Although cancer fears are more common, cardiovascular disease is the chief cause of death and disability in the United States today. It affects close to 60 million Americans and every year more than a million people suffer from new or recurrent heart attacks. In fact,every 20 seconds a person in the United States has a heart attack, and one-third of these attacks leads to death. The American Heart Association calls CVD “the silent epidemic.”

12) False. For years we were told that a heart-healthy diet included foods low in fat and high in carbohydrates, such as fruits, veggies, legumes, grains and other starches. But now experts are saying that overloading on carbohydrates (especially the wrong kind) can make you fat and increase your risk of heart disease. Eating foods with a high glycemic index—such as cookies, cake, candy, bagels, pasta, white rice, refined bread and grains, potatoes and potato chips—raises blood sugar and insulin levels, which in turn stimulates the production of triglycerides (blood fats that raise heart disease risk).

13) False. Your kidneys, blood vessels and heart all control blood pressure. In order to maintain healthy blood pressure and keep blood moving, the walls of your arteries, capillaries and veins need to be flexible and strong. Research has shown that nutrients such as Co-Q10, hawthorne, red wine polyphenols, notoginseng (a cousin of ginseng), and astragalus help strengthen blood flow throughout the entire body, maintaining healthy blood pressure. In addition, EDTA (the main ingredient in Health Freedom Nutrition’s Cardio Clear) removes heavy metals and toxins that interfere with the production of nitric oxide, a major factor in controlling blood pressure.

14) False. Even if there’s heart disease in your family, and even if you have high cholesterol, combining an regular exercise program with and a Mediterranean based diet and healthy lifestyle (no smoking, reduced alcohol consumption) can dramatically reduce your risk of heart attack and stroke.

15) True. Dr. Scoot Calig, M.D., a pediatrician at West Hills Medical Center and an assistant clinical professor at the University of Southern California, Los Angeles, says, “It’s important to keep in mind that the development of cardiovascular disease begins in the teenage years. Studies have shown that by that time, arterial plaque formation is well under way.”  Just another reason to exercise, eat a healthy diet, and take nutritional supplements such as oral EDTA to strengthen the heart and arteries and clear out toxic metals that inhibit the production of nitric oxide.

16) False. For years, aspirin has been prescribed after a heart attack, in order to avoid a subsequent heart attack. And now, a panel of experts is recommending aspirin as a precaution against heart disease for all at-risk, healthy adults over 40. But Alfred Berg, M.D., of the University of Washington, head of the panel says, “Do not assume that an aspirin a day is without risk.” Aspirin can cause intestinal bleeding and hemorrhagic stroke. Herbs such as hawthorne, nattokinase, garlic and Ginkgo biloba have the ability to thin the blood like aspirin, without damaging the esophageal and intestinal linings, or exacerbating ulcers.

17) False. Homocysteine—a by-product of the amino acid methionine— is a more sensitive indicator of cardiovascular health than cholesterol. Too much of it increases injury to arterial walls, as well as accelerates oxidation and accumulation of cholesterol in blood vessel. The good news is that folic acid, and vitamins B6 and B12 help keep homocysteine levels low!

18) True—for men and women! Click here to read 16 Stress-busters to nourish your body, mind and soul

Have a happy Father’s Day, and please take care of your health so you can continue to enjoy life and be a support and friend to everyone who loves you.


For dozens of general health tips and caregiving help read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia  by Barbra Cohn.image

12 ways to protect yourself and loved ones from Elder Abuse

senior woman with her hands signaling to stop over light backgroundWorld Elder Abuse Awareness Day is June 15th and according to the World Health Organization elder abuse is a violation of human rights and a significant cause of illness, injury, loss of productivity, isolation, and despair. It touches people across all socioeconomic groups, cultures, and races. But only about one in five cases is ever reported. People with dementia are particularly vulnerable because they are unable to recognize that they are being abused or to report it.

Also, people who have diminished eye sight or hearing, or are confined to a wheel chair are vulnerable. My friend’s father who has macular degeneration and is hearing impaired was scammed out of thousands of dollars by a caller who claimed that she was his niece. She claimed that she was being held in jail and needed bond money. This family emergency scam has been going on for years.

Verify an Emergency

If someone calls or sends a message claiming to be a family member or a friend desperate for money:

  • Resist the urge to act immediately, no matter how dramatic the story is.
  • Verify the person’s identity by asking questions that a stranger couldn’t possibly answer.
  • Call a phone number for your family member or friend that you know to be genuine.
  • Check the story out with someone else in your family or circle of friends, even if you’ve been told to keep it a secret.
  • Don’t wire money — or send a check or money order by overnight delivery or courier.
  • Report possible fraud at ftc.gov/complaint or by calling 1-877-FTC-HELP.

Another friend’s mother lived in Florida where she had round-the-clock nursing care in her own home. At the end of her life she suffered from dementia and was frail and bed-ridden. When Cheryl (name has been changed) went for a visit, she discovered that her mother had been cruelly beaten, and even though her two caregivers were women, it was apparent there she had been sexually abused. The poor woman’s genital area was swollen and bruised.

Physical abuse is not the only type of abuse targeted at the elderly. I know of two families who lost their inheritance because of financial fraud and theft. In one family the elderly father was cared for by a young woman who convinced him to marry her in order to be the beneficiary of his estate. The man’s family was unable to get a penny or access to the family home they had grown up in. Another elderly man assigned a trustee to overlook his financial affairs. The trustee stole his money and even though one of his adult children is a lawyer, the family was unable to recover a penny of their inheritance.

We’ve all heard of telephone scams in which a caller claims he is a jailed grandson who pleads with his grandparents to send bail money, or the IRS scam where the caller threatens severe consequences if the senior doesn’t pay tardy taxes.

These types of occurrences are all too common, especially in under staffed, under funded nursing homes.

Report abuse

Abuse can occur anywhere: at home, in nursing homes, and memory care homes. If you suspect abuse don’t hesitate to report it. You do not have to prove anything. It is up to the professional staff to investigate your suspicions, and put the proper safety measures in place.

Types of abuse

  • Physical–causing pain or injury
  • Neglect–failure to provide food, shelter, clothing, medical and other necessities required to provide a safe, nurturing environment
  • Emotional and Psychological—Verbal assaults, harassment, threats, intimidation
  • Confinement –restraining or isolating the person
  • Financial—Scams, misuse or withholding of the person’s financial resources to the disadvantage of the elderly person, and to the advantage of another person.
  • Deprivation—Denying the person medication, medical care, food, shelter or physical assistance
  • Sexual abuse –Any sexual activity, including fondling, when the person is unable to understand, unwilling to consent, or threatened or physically forced

Signs of abuse

  • Bruises, pressure marks, broken bones, abrasions and burns
  • Bruises around the breasts and genital area could indicate sexual abuse
  • Poor hygiene, bed sores, unattended medical needs, unusual weight loss
  • Sudden withdrawal from normal activities, unexpected depression, and a sudden change in alertness can be an indicator of emotional abuse. However, these symptoms can be the result of a progression of dementia or other disease.
  • Sudden changes in financial situation can be a result of exploitation.
  • Aggressive behavior from a caregiver or from the person being cared for can result in verbal or emotional abuse on either end.

Caregivers also are the recipients of abuse from the person they care for. If a caregiver feels physically threatened it’s important to get help in providing safe care for the person being cared for, possibly in a facility.

What can you do to protect yourself and your loved ones?

Report suspected mistreatment to your community’s Human Services Adult Protection agency and/or law enforcement office. Even if a situation has already been investigated, if you believe circumstances are getting worse, continue to speak out.

If you or others experience abuse or neglect in a community setting:

Adult Protective Services (APS) is there to help. The APS mission is to ensure the safety and well-being of elders and dependent adults. Unfortunately, it is estimated that millions of U.S. elders, from all walks of life, face abuse and neglect every year. Anyone can be victimized. However, there are things you can do to help protect yourself from abuse and neglect…

Human Services provides help with:

  • In-home assessment for abuse, neglect, and/or exploitation
  • Crisis intervention
  • Monthly visits by a case worker, if risk continues
  • Assistance with housing and/or placement to alternative housing
  • Assistance with obtaining benefits
  • Money management
  1. To report suspected abuse in a nursing home or long-term care facility, contact your local Long-Term Care Ombudsman. Each licensed long-term care facility is required to display a poster with the facility’s assigned ombudsman’s name and contact information. If you are a resident or family member of a resident in a facility, call the ombudsman listed on the poster. To learn more about the ombudsman program visit: Long-term care ombudsmen are advocates for residents of nursing homes, board and care homes and assisted living facilities. http://www.ltcombudsman.org
  2. Caregivers (both family and professionals) are most often the abusers of the elderly. Stress and feelings of being overwhelmed may provoke unintentional belligerent feelings. If you feel overwhelmed or frustrated as a caregiver, talk to someone for support.
  3. To speak with an Alzheimer’s Association Care Consultant call: 1-800-272-3900
  4. To find a support group in your area visit http://www.alz.org/apps/findus.asp
  5. To receive support from other caregivers visit https://www.alzconnected.org/
  6. To report an incident or concern of abuse or neglect, call the Alzheimer’s Association (1.800.272.3900) or Eldercare Locator (1.800.677.1116). You’ll be connected to your state or local adult protective services division or to a long-term care ombudsman. You do not need to prove that abuse is occurring — it is up to the professionals to investigate suspicions.
  7. Read more: http://www.alz.org/care/alzheimers-dementia-elder-abuse.asp#ixzz2W9DhCbSL
  8. Keep in contact. Talk with your older friends, neighbors, and relatives. Maintaining communication will help decrease isolation, a risk factor for mistreatment. It will also provide a chance to talk about any problems they may be experiencing.
  9. Join Ageless Alliancea national, non-profit grassroots organization working to promote aging with dignity and eliminate elder abuse, neglect and exploitation through Awareness, Advocacy and Action. Based at the Center of Excellence on Elder Abuse and Neglect at the University of California, Irvine, Ageless Alliance is a grassroots campaign to give a voice to those who have been affected by elder abuse and abuse of adults with disabilities.
  10. Plan ahead to protect against financial exploitation. Download a handout on ways to protect yourself or a loved one.http://www.ncea.aoa.gov/Resources/Publication/docs/NCEA_ProtectYourself_web508.pdf
  11. Be aware of the possibility of abuse. Look around and take note of what may be happening with your older neighbors and acquaintances. Do they seem lately to be withdrawn, nervous, fearful, sad, or anxious, especially around certain people, when they have not seemed so in the past?
  12. Contact your local Area Agency on Aging (AAA) office to identify local programs and sources of support, such as Meals on Wheels. These programs help elders to maintain health, well-being, and independence—a good defense against abuse. See the Eldercare Locator, www.eldercare.gov Welcome to the Eldercare Locator, a public service of the U.S. Administration on Aging connecting you to services for older adults and their families.You can also reach us at 1-800-677-1116.

You have a dementia diagnosis, now what?

Senior doctor talking with patient and tablet in officeJune is Alzheimer’s & Brain Awareness Month. It’s a good time to have a physical exam, especially if you are worried about your memory not being as sharp as it used to be or if you’re having trouble coping with daily life. If you’ve noticed that someone close to you is showing signs of withdrawal, depression or confusion, please strongly suggest that he or she make an appointment for an exam, too.

Here’s the scenario of how my husband Morris and I received his diagnosis. I’ve provided a list below it to help you tread water when you feel as though you’re drowning.


There were several indications that something was wrong with my husband two years before he was diagnosed. This tall, good-looking man, a graduate of the Wharton School of Business at the University of Pennsylvania, was having trouble calculating how much tip to leave a waitress. When we went to Spain for our twenty-fifth anniversary, Morris couldn’t figure out how much money the hotel would cost in dollars. This man, who once memorized train and airplane schedules without even trying, followed me around the city like a puppy dog as we boarded a subway or bus en route to tourist attractions.

That following fall—our daughter’s last year in high school—Morris couldn’t give directions to a friend who was taking the SAT at the high school my husband had attended in Denver. I got out the map to help him, but he couldn’t read the map. That was the moment I knew something was very wrong. When he left for a road trip to California with our son and forgot his suitcase, I sat on the stairs and cried. I couldn’t deny it any longer. I had a strong suspicion that Morris had Alzheimer’s disease, and although I pleaded with him for two years to see a neurologist, he refused.

Finally, he agreed. The doctor (I’ll call her “Dr. Fitzgerald”) asked Morris why he had come in. “My wife thinks I might have Alzheimer’s disease,” he said.

“You wouldn’t be able to drive here yourself if you had Alzheimer’s,” she replied.

Nonetheless, Dr. Fitzgerald gave Morris the Mini-Mental State Exam (MMSE, a thirty point questionnaire used to screen cognitive impairment), asking questions such as, “What are the year, season, date, day, and month?” and progressing to more difficult questions that included counting backward from one hundred by serial sevens. I don’t know about you, but I’d probably be slow on the draw to count backward by sevens. At least I’d have to stop and think about it before responding. Morris botched up that question, and he wasn’t able to draw the face of a clock either. The concept of time was already an elusive abstraction.

Dr. Fitzgerald ordered a blood work-up to rule out an organic problem such as hypoactive thyroid—which can cause memory problems—and an MRI scan (magnetic resonance imaging) to rule out a brain tumor. To tell you the truth, I was hoping for a brain tumor because at least you can take the bull by the horns and really go at the darn thing with radiation and a scalpel. Well, there was no brain tumor and his blood panel looked just fine.

A week later, just as we were investigating the cost of long-term health insurance, Dr. Fitzgerald called to ask Morris to bring in his wife to the follow-up appointment. I’m sorry to say that one of the biggest mistakes I’ve ever made was to schedule that appointment without first buying long-term care insurance. Once you get a diagnosis such as Alzheimer’s, there’s no way you’re going to qualify for long-term care insurance, which could potentially save a family thousands of dollars in catastrophic health care costs.

In the early afternoon of January 3, 2001, Morris and I sat in a dimly lit exam room on wooden frame chairs with hunter green cushions on the seat and back. He wore a sweater woven from various shades of blue and gray that highlighted his eyes. We waited for the doctor to knock on the door, the way they usually do. Morris didn’t appear nervous; probably because he didn’t think there was anything wrong with him. But my stomach was wound tight from anxiety and my lungs were working hard to expel phlegm. It didn’t help that the stale re-circulated air had a metallic odor of fear that was probably generated by patients who had received bad news.

Dr. Fitzgerald finally came in and sat on Morris’s left. She had cropped hair and spoke in a blunt, choppy cadence that matched her no-nonsense appearance. Without much of an introduction, the doctor asked me a few questions about Morris, speaking as if he were invisible.

“How is his driving?” she asked.

“He tends to get lost driving in familiar neighborhoods,” I responded, noting the twitch in Morris’s right cheek. I felt my lungs squeeze, and a high-pitched wheeze escaped from my chest.

“Here is the Mini-Mental State Exam Morris took the last time we met.”

His drawing of a house looked like a dilapidated mine shaft. Without waiting for a response, Dr. Fitzgerald turned to Morris and said, “You have Alzheimer’s disease.” Morris froze and his face turned white, while I burst out crying.


I hope that if you ever get a diagnosis such as Alzheimer’s, Parkinson’s, vascular dementia or a similar devastating disease, your doctor is compassionate and gentle about the delivery of the news that will forever change your life and the lives of your loved ones. I wrote “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia” after caring for my husband for 10 years, in order to help other caregivers feel more confident, happier, healthier, and deal with feelings of guilt and grief.

For hundreds of other caregiving tips, find “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia” on AmazonBarnes and Noble, at other fine book stores, and many libraries.

 

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What can and should you do after getting a diagnosis?

It is understandable that you will have many conflicting feelings such as disbelief, anger, depression, sadness, fear, grief, and shock. You may even feel relieved that you finally know why you are not feeling like yourself. It can be helpful to talk about what you’re feeling and thinking rather than to keep things bottled up inside. In addition to talking with people who are close to you, you can contact the Alzheimer’s Association® at 1.800.272.3900.

You don’t have to tell everyone about your diagnosis if you don’t want to. But if you are still working, or if your boss has questioned your work habits, etc., it’s a good idea to inform him or her of your diagnosis, especially since you might be eligible for  Social Security Disability Insurance.

Your health is more important than ever

Just because you receive a diagnosis doesn’t mean you should give up trying to live a healthy life. You probably still have a lot of years ahead of you, so enjoy them as much as you can. Continue to get daily physical exercise such as walking, biking, hiking, dancing, swimming. Eat a Mediterranean based diet that includes lots of fresh veggies, fruits, nuts,  fish, whole grains, avocado and olive oil.

Stay socially connected as much as possible. It’s normal to feel depressed and it’s okay if you don’t feel like “going out” as much as you used to. But it’s important not to isolate yourself. Keep golfing, bowling, playing cards, as much as you can. Continue to meet with friends for lunch or a movie. If you feel the need to talk, make an appointment with a therapist who specializes in helping people with dementia.

Visit museums, spend time with grandchildren, get a pet (if you don’t already have one), attend an Alzheimer’s Association Memory Cafe. The Alzheimer’s Association’s Memory Cafés offer a fun and relaxed way for people living with early-stage memory loss to get connected with one another through social events that promote interaction and companionship. This is a place where the care partner can receive information while connecting and sharing with other people in similar situations.  Keep busy!

 Legal and Financial Planning for the Future

This is the time to start planning for the future. Taking the time to make decisions about matters that will affect your health care and your finances before you are unable to manage them is one of the most important steps you can take for yourself and your family.

There are many legal and financial documents that will help you formalize your plans and wishes such as:

Durable Power of Attorney

In this document you appoint a person you trust to make legal and financial decisions on your behalf, if you become unable to do so for yourself.

Health Care Proxy

In this document you appoint a person to make medical decisions on your behalf, if you become unable to do so for yourself. It’s important that you speak with the person you appoint about the kind of medical care you would or wouldn’t like so that they can carry out your wishes.

Living Will

Some people also want to make a Living Will in addition to having a Health Care Proxy. In this document, you can state your wishes about end-of-life care.

Last Will & Testament

The purpose of this document is to designate how your assets will be distributed after your death. This will must be completed with the assistance of an attorney.

All the best to you and your families. 

With love,

Barbra Cohn