Tips on Preparing for an Appointment With Your Doctor

Supporting Independence and Aging with Dignity: Understanding Care Management and Advocacy Services for Older AdultsAs the population ages, more families are finding themselves navigating the complex and often overwhelming world of elder care. From managing chronic health conditions to arranging safe housing and transportation, supporting an older adult through the aging process requires careful planning, clear information, and access to the right resources.One model that has become increasingly important in this landscape is care management, a service designed to bridge the gaps between families, healthcare providers, and community support systems. Organizations like Solutions for Independence, based in Western Pennsylvania, offer insight into how this model worksand why it matters. What Is Senior Care Management?Senior care management is a professional service that helps older adults and their families coordinate care and make informed decisions. Often led by certified care managers or aging life care professionals, these services typically include: Assessing the individuals physical, cognitive, and emotional needs Coordinating medical care and follow-ups Identifying appropriate community resources Providing support to family caregivers Assisting with transitions from hospital to home or residential care Care management can be particularly useful in complex situationssuch as when a loved one has multiple medical conditions, lives alone, or doesnt have family nearby. Its not about taking over decision-making; rather, its about providing clarity, expertise, and personalized planning. The Value of Advocacy in Elder CareAnother critical area in the aging process is advocacyespecially when it comes to navigating healthcare systems and long-term planning. Advocacy services focus on ensuring that older adults receive care that aligns with their values, preferences, and rights.Advocates often step in to: Communicate with doctors and insurance providers Help seniors and families understand legal tools like Power of Attorney Navigate public benefits such as Medicaid, Medicare, or Veterans programs Mediate family disagreements around care While medical professionals often concentrate on diagnoses and treatment, advocates take a broader viewone that includes quality of life, dignity, and autonomy. Aging in Place: A Growing PriorityAccording to AARP, nearly 90% of older adults say they want to age in place. But doing so safely and comfortably requires planningand sometimes, professional input.Services like home safety assessments can make a meaningful difference. These evaluations often identify risks such as poor lighting, slippery floors, or lack of grab bars. Recommendations may include home modifications, adaptive equipment, or the introduction of in-home care services.Some care management organizations partner directly with home health providers, physical therapists, and contractors to implement these changes. By focusing on prevention, they help reduce the risk of falls and hospitalizationstwo of the most common and costly events in older adults lives. Empowering Family CaregiversFamily caregivers are often the unsung heroes of elder carebut they can also experience burnout, decision fatigue, and emotional strain. Thats why more families are turning to services that support and coach caregivers through these challenges.Common areas of support include: Education on chronic illnesses like dementia or Parkinsons Respite care coordination Assistance with managing medical records and appointments Help during crises, such as hospitalizations or care facility transfers In these situations, a care manager or eldercare consultant can act as a neutral guide, helping families navigate tough conversations and make informed choices without the burden falling on one person. Planning for the Financial Side of CareSenior care can be expensive, and understanding available financial support options is crucial. Benefits counseling is one lesser-known but incredibly valuable service offered by many eldercare professionals.This may involve: Identifying eligibility for Medicaid waiver programs Applying for the VA Aid & Attendance pension Reviewing long-term care insurance policies Estimating out-of-pocket care expenses Advising on estate planning tools, often in partnership with legal professionals Even families with means can benefit from this guidance, especially when trying to preserve assets while ensuring quality care. A Collaborative Model for Aging WellUltimately, organizations that provide care management and advocacy serviceslike Solutions for Independencerepresent a collaborative model for aging. They don't replace the role of family or healthcare providers but instead act as coordinators, educators, and facilitators, working across disciplines to support seniors in maintaining autonomy and quality of life.Whether you're helping a parent recover after surgery, navigating a new dementia diagnosis, or simply planning for the future, knowing these services exist can make a tremendous difference. Aging well isn't just about good medical careit's also about having the right guidance, support, and plans in place. Care management and advocacy services are essential tools in this process, helping families make confident, informed decisions during what can be a challenging and emotional time. If you're starting to think about elder care for a loved oneor even for yourselfconsider learning more about care management and how it might fit into your plan. The more proactive you are, the more options youll have to ensure safety, independence, and peace of mind.

It is a sad commentary on our current cultural worldview that sunlight is widely perceived to be harmful, a cancer-causing threat. But what does the research actually say? And does this research affect older adults differently than other people?Spectrum: For starters, we should understand that sunlight is a complex combination of photons, with different wavelengths and properties. The sun is the original full-spectrum illumination, while both incandescent and LED lights emit, as one might expect, mostly visible-spectrum light.Intensity: The other important variable is the intensity of light, measured in LUX units (a foot away from one candle): direct sun comes in at 100,000; a cloudy day at 1,000; a kitchen or office measures 500; and a living room only 50. Thats why you need to get outside.UV: At one extreme is ultraviolet light (UV), whose wavelength is slightly shorter than visible violet. With regard to our health, UV is a mixed bag.It does cause sunburns, damages DNA, and triggers the aging of skin. It is also statistically associated with malignant melanoma, although, curiously, not with increased deaths from melanoma (because these cancers are mostly treatable).On the other hand, there are numerous health benefits: UV lowers the risk of hypertension, diabetes, atherosclerosis (hardening of the arteries), blood inflammation, and COVID infections. UV also stimulates Vitamin D synthesis in the skin. A large-scale study of 500,000 Brits, with a 12-year follow-up, found that frequent UV exposure lowered all-cause mortality by 14%, with cardiovascular deaths down 21% and total cancer mortality decreased by 13%. It gives one pause to reconsider the vast sums spent on sunscreen lotions. Just wearing light summer clothing blocks 80% of UV.IR: UV radiation represents only about 3% of the sunlight that strikes the surface of the earth, while about 50% is infrared (IR), whose lightwaves are just beyond (longer) than visible reds. IR radiation is more predominant at the beginning and end of days, while UV is strongest when the sun is overhead. A thick cloud cover reduces IR significantly more than UV. In a recent superb Huberman Lab podcast, Dr. Roger Seheult touted the many benefits of IR radiation. Most severe and chronic diseases also involve mitochondrial dysfunction (mitochondria are the small organelles within a cell that produce the energy-generating chemical ATP). One aspect of aging is that we lose 70% of our mitochondrial functioning after age 40. Unlike UV, IR radiation passes through light clothing and the surface of the skin to penetrate deep into body tissues, where it significantly stimulates mitochondrial ATP synthesis.Effects: The effects of improved mitochondrial functioning are pervasive, correlated empirically with sun exposure. Dr. Seheult cited statistics demonstrating that the greatest number of all-cause mortality comes soon after the shortest day of the year, and the lowest number of deaths occurs close to the longest days.People who live far north or south of the equator where days are particularly short in winter have higher overall mortality rates, particularly in mid-winter. In a study of almost 30,000 Swedish women, avoidance of sun exposure carried the same risk of premature death, as did smoking.There is well-replicated rigorous research that moderate IR exposure lowers the risk of cancer, heart disease, diabetes, hypertension, and it reduces blood lipids and chronic inflammation. IR increases immune system response to infections, such as influenza, COVID and pre-cancerous cells.On a sunny day, just 15 minutes outside can make a big difference. If youre in a green space with lots of grasses, leaves, bushes, and trees, you can receive two to three times the IR dose because plants reflect much of the IR that strikes them (notice that most leaves dont get hot in the sun because of these reflective properties).Red Light Therapy: There are many red-light therapy devices now available if you are considering them, be sure to carefully research IR wavelengths, dosage, safety, and therapeutic benefit. One study, utilizing an IR desk unit shining only on face, neck, and hands, proved to be quite therapeutic.Forest Bathing? Dr. Seheult delighted in reminding us of the wisdom of the ancient beliefs that sunlight and fresh air promote convalescence. Forest bathing has become a thing the air around trees is infused with phytoncides that defend plants from bacteria, fungi, and insects. When inhaled by humans, they up- regulate immune functioning and lower stress levels, and reduce stress hormones. The beauty and serenity of such an environment further enhances these benefits, some of which are detectable by lab tests a month later. Furthermore, getting up with the sun (and out from behind the filtering effects of plate glass windows) helps to set your circadian rhythm, which can improve sleep patterns. Take home message: forests, parks and even golf courses soothe the soul, and the body. And early morning and late afternoon may be particularly beneficial.Sweat Benefits: Dr. Seheult is a pulmonologist who treats many respiratory infections he also reminded us about how previous generations treated patients with hot baths and hot packs, as if to sweat out infections. Its been recently discovered that body temperatures a little over 100 degrees Fahrenheit actually accelerate the production of interferon, a powerful anti-viral protein. Maybe weve been a little too quick to reduce our fevers with aspirin, Tylenol, and Advil. And maybe the saunas so favored by Scandinavians and Russians are more therapeutic than weve realized.Conclusion: As spring has sprung, we encourage everyone to get away from your screens, go outside and enjoy the benefits of the sunshine that so amply surrounds us. Residents at Kavod Senior Life have a myriad of ways to get outside, whether it be on the sunlit patio areas, in the resident gardens, on the nearby walking paths in Cherry Creek or on the many benches and sitting areas surrounding the campus. Come for a visit and see for yourself!Ben and Scott  https://theagingwiselyproject.com/

By Faith Protsman, MD, Regional Medical Director, VITAS HealthcareVietnam War veterans face unique obstacles throughout the twilight of advanced illness. For hospice care providers to tailor care to meet the needs of veterans who have served in this theater of war, they must consider the tribulations these patients face as they reach the end of their lives.The Vietnam War era was a very tumultuous time to be a soldier. The United States' prolonged involvement in a war of questionable motivation left society with disdain toward the government and its institutions, especially the military.Coupled with horrific images shown on television, constant controversy was a new reality and negative public opinion formed around this conflict, of which those serving the nation were not spared.Careful consideration is necessary when treating patients facing these traumas.Tours of duty proved to be traumatizing in many ways. Young soldiers, some having just turned 18, were drafted into a war that many of them did not believe in. They were not fighting for love of country and God; rather, they were fighting for survival and out of fear for their lives.Intimate battles in the dense jungle led many to be subjected to the horrors that come with fighting in a foreign land that was only familiar to the elusive guerilla enemy soldiers.Servicemembers did not receive a warm welcome when returning home from Vietnam, often being judged and labeled as cruel and even inhumane.Moral Injury Can Impair Mental HealthThis perfect storm of trauma led to lasting moral injury that plagues many veterans for their entire lives. Veterans returning from the war were marginalized and pushed into isolation, often turning to alcohol and substance abuse, which worsened their anxiety and exacerbated their strife.Questions like Ive never spoken about the war, can I now? Was the war moral or immoral? and Was I a good soldier? come bubbling to the surface later in life as their illnesses intensify and their defenses weaken.Careful consideration is necessary when treating patients facing these traumas.The restlessness that can result from post-traumatic stress disorder (PTSD) is often treated with benzodiazepines. In most cases, these medications can bring relief through calming the patient.Yet, there is a common trend amongst veterans who cope with trauma that results in the opposite effect.Benzodiazepines can lower the walls that Vietnam veterans have built up throughout a lifetime of suppressing trauma and negative memories. This class of medications can exacerbate the symptoms of PTSD as traumatic experiences and feelings of regret resurface. Benzodiazepine-induced inhibition of neurotransmission can even lead to agitated toxic psychosis, increased anxiety, hostility, and rage.1The Value of Compassion Along with Clinical CareRemaining considerate does not end with simply staying mindful during the planning of clinical solutions. Providing care for Vietnam veterans requires a high level of empathy.A key to an empathetic approach is taking the time to listen nonjudgmentally. Though seemingly simple, practicing nonjudgmental, open communication with patients facing trauma from war can help avoid the all-too typical responses of Its okay and You did what you had to do.These patients do not need sympathy, because they have been judged enough throughout their lives. When care teams approach them without judgment, they honor the sacrifices these heroes have made.VITAS hospice care provides compassionate care approaches that are tailored to meet the distinctive needs of Vietnam veterans. With the Veterans Administration (VA) offering hospice care as part of its medical package, VITAS team members can provide empathetic psychosocial support, while utilizing clinical solutions that help manage symptoms.The qualifications for veterans to receive hospice benefits include: A life-limiting illness Treatment goals that focus on comfort, rather than curative treatments A life expectancy of 6 months or less, if their illness runs its normal course Veterans also benefit from the option to receive concurrent care through the VA. The VA can provide curative treatments as the patient simultaneously receives symptom-managing comfort care administered by the hospice care provider of their choosing.Offering solace, while remaining compassionate when patients need it most, is too often overlooked in the busy practice of healthcare. Acknowledging the adversity that Vietnam War veterans have had to face throughout their lifetimes and adapting care approaches to meet their needs is the best way for healthcare providers to give back to those who have sacrificed so much for the preservation of freedom.1Paton, C. (2018, January 2). Benzodiazepines and disinhibition: A review: Psychiatric bulletin. Cambridge Core. Retrieved November 2, 2022, from https://www.cambridge.org/core/journals/psychiatric-bulletin/article/benzodiazepines-and-disinhibition-a-review/421AF197362B55EDF004700452BF3BC6