7 Categories for Brain Health Safety and Improvement

This information is brought to you via emails from www.bebrainpowerful.org

To keep your brain and your body in tip-top shape follow these simple guidelines:

1.    Food and nutrition – Eat Smart

2.    Physical exercise – Get Your Body Moving

3.    Rest and relaxation – Rest Well/Meditate Deeply

4.    Medical health – Avoid Medical Risks (which links directly to #1, 2, and 3)

5.    Mental Fitness – Strengthen Your Brain by Putting It to Use

6.    Social interaction – Stay Connected

7.    Make an impact – Advocate, Educate, Join, Encourage

On the Next Visit to With Your Doctor...

ASK THE QUESTIONS: 

1.    Are there things I can do today (eating right, mental and physical exercise, etc.) to help 

preserve my cognitive health? Please give me a potential regime.

2.    How can I test or track my cognitive health over time? Is there a good record book for this?

3.    If I’m feeling concerned about my cognitive health, or if I notice symptoms of Alzheimer’s or other dementias, what steps should I take? How can I distinguish between Alzheimer’s and normal aging? Who are my best contacts? What actions should I take now and plan for in the future?

4.    My family has a history of dementia – how can I best prepare myself and my family? What are the best resources to guide me and my family along this potential journey?

5.    I’d like to help support women’s brain health research. Are you aware of any clinical trials I might qualify for? 

www.bebrainpowerful.org 

Women and Alzheimer's Disease

KNOW THE FACTS ABOUT ALZHEIMER’S DISEASE

• Alzheimer’s places an unequal burden. Women are twice as likely to suffer from Alzheimer’s disease as men, making up 2/3 of the 5.7 million people in the United States living with dementia. 
• Alzheimer’s is a pressing issue. After the age of 65, women are twice as likely to develop Alzheimer’s as breast cancer.
• It’s Time to Talk. 60%-80% of cases of cognitive impairment in individuals above the age of 65 go unrecognized, undiagnosed, not addressed. Join “Let’s Talk About It” – a safe discussion group that meets the 2^ndWednesday of each month at 10:20 am at Humboldt General Hospital.  

You Are Not Alone. Nearly 70% of women surveyed by Women Against Alzheimer’s and Healthy Women expressed interest in learning more about how to measure and track their brain health. 

KNOWLEDGE IS POWERFUL

Dementia, Alzheimer's, and Legal Planning

I am not an expert on legal planning and so my first recommendation has to be to schedule an appointment with your lawyer, an elder lawyer, or financial planner as you gather up your legal papers and prepare for a visit. You want everything laid and and smooth for the future with matters concerning health decisions, financial expectations, and final wishes. Letting family know now, when you are of sound mind and body, alleviates problems and confusion in the future.
Many families have Powers of Attorney in order, however, sometimes possibilities are not considered such as moving to another state (when sometimes legal papers do not cross state lines) or changes in family status or finances. Such documents need to be reviewed each year so that everyone is current on future plans.
It is also important that should you become incapacitated, unable to control your own destiny, other may step in with their demands. For example, if you have listed "no heroic measures" are to be undertaken to save your life when it is ready to be complete, a spouse or child may decided s/he is not ready and thus a life may be prolonged while legal and medical matters are sorted out.
In your desire to make everything fair, often this is impossible. Everyone has a slightly different description of "fair". Sue gets Grand-dad's old car - valuable but something she has no interest in preserving - while Alex receives a hefty check. While the two are of apparent equal value one is a potential pay-out while the other has immediate cash value. Suppose Sue wants to sell the old-mobile but the family sends a flurries of "No!" It is hers to sell but at what price in relationships?
After your visit with counsel, you'll have a better idea of how to divide your estate and estate responsibilities evenly. You also need to communicate this orally or in writing in advance. No surprises may prevent at least some potential squabbles when you can longer speak up.

Holiday Thoughts - Adjusted Expectations

Tips for Creating a Smooth and Enjoyable Holiday

• ·     Familiarize invited guests with household changes
•    Do what only what feels reasonable and within your limits - potluck is fine
• ·     Involve your loved one who has dementia in safe, manageable activities
• ·     Maintain normal routines as much as possible
• ·     Build on traditions and memories
• ·     Adapt gift-giving – gifts that are useful like ID bracelets, photos albums, easy-on-and-off clothing
• ·     Avoid gifts like difficult board games, puzzles with too many pieces, complicated electronics, surprise pets
• ·     Try to be flexible – think about celebrating with brunch or lunch instead of dinner. Evenings and darkness add to confusion.
• ·     Avoid excess noise and crowds
• ·     Share good times and celebrate joy

Accessible Bathrooms

Anyone with infants or small children can relate to the disastrous feeling upon entering a bathroom to find no changing table available. Although over time more and more of these have appeared in women's bathrooms, Dads sometimes need to change diapers, too. Their choices? A knee balancing act, a public bench, or eek! the floor of the men's bathroom - or any bathroom, for that matter. The same is true for caregivers with a loved one with incontinence. Imagine the chagrin of dripping or messy pants while out shopping with no family accessible bathroom. Yes, the twosome can jam into a single stall or wiggle into a handicap accessible stall, but what if the caregiver is female and the care recipient male? Then what? Women tend to gawk or squawk as a man is led by the hand into the secret potty realm; men tend to look puzzled and embarrassed. Regardless of reception, changing an adult's pants is difficult, messy, impossible in cramped quarters, and a heartbreak.
You might wonder, Why not just stay at home? Why not just leave the loved one in the car? Why not buy adult diapers? While each of these is a potential solution, to maintain a sense of normalcy and purpose, it is important for caregivers to get out; it is equally important for care recipients to maintain a semblance of former routines. While in later stages of dementia adult diapers can be "snuck" on, in the early stages a formerly dignified and independent individual is now faced with the humiliation of wadded bundles of padding bulkily sticking out of pants hat odd angles. Who wants this?
One solution is, of course, education. the public needs to realize the value of trips out and the need for restroom stops. Family bathrooms are a super solution. And if space and adequate room do not exist, informed business owners and employees who assist the caregiver and clear the bathroom area are needed and much appreciated. Being kind is the right decision.

Time Flies

With all good intentions I plan to write 1-2 blogs each week. And as with many good intentions, it is now one month later and I have finally returned to this screen, this site, and my designated/promised blog.
Coming to Winnemucca (and to your community as well if you contact me) is the Dementia Friends presentation. The goals of DF include educating the public - family, friends, business owners, employees, visually everyone - about how to best help those with dementia. It takes all citizens working together to create a perfect community, and that is a what DF is all about. Let's examine a few of these:
Health Care - We need services that promote early diagnosis, potential interventions, and best practices. Often health care professionals are afraid to mention "Alzheimer's disease", for example because it carries such a devastating stigma. With no reversal, no cure, and no prevention, it does sound dismal. However, education is one step in the solution to making wise and beneficial choices. A prescription and a bandaid do nothing to solve dementia, but knowing resources and seeking them out is so helpful.
Businesses - We need business and provided dementia-informed services and environments that are peaceful and friendly for those with dementia and their loved ones who are working to navigate the intricacies of this disease. Family bathrooms, lever handles, chairs and benches, calming music, and a friendly smile are all part of supporting those with dementia as they try to maintain a "normal" lifestyle.
Transportation - We need buses, taxis, Ubers, trains, and planes that are accessible for those with handicapping conditions including dementia. Confusion occurs about how to open a car door, how to enter the seat correctly, how to buckle (and later unbuckle) the seatbelt. Wise drivers plan ahead, have a helping hand ready, calm music playing, and a friendly voice resonating. These drivers understand that someone with dementia may be lost, unsure of directions, scared by sudden changes in movement and direction. They make sure that passengers arrive safely as they guide them to family or friends in a pleasant environment.
to be continued - within a few days!!

The Word: Dementia

Many individuals and groups have tried to drag the word "dementia" out of the closet and into full view. Doing this is the best way to confront the issue and the stigma attached, however, now it seems some formerly strong voices are backing off, determining that"dementia" is a word that is just too frightening. Because of this people are turned off to a conversation on the subject before the subject is even discussed.
This back and forth has made me confused. Am I supposed to tiptoe through the tulips, so to speak, or shout out the word loud and clear? Can we make a difference in educating others if we are afraid to even utter the word? I understand, on the one hand, the need to proceed with due caution; I also understand that hiding the truth means we will never truly face and solve the confusion and misconceptions about "dementia".
Dementia takes various forms, some less severe, others terminal. Regardless of the form, let's talk about it. Let's discuss the issues and angles. Let's decide how we can make a difference in the lives of those in need.
Let me know - should we disguise dementia and present it as a potential cognitive decline, especially as we age, but that people can live long and well inspire of it?

What Is a Dementia Friend?

Many say we should just throw out the terms dementia and Alzheimer's because of the stigma attached to them. The problem with tossing these words is that we do not really face the reality of forgetfulness that permanently changes the life of an individual and by extension, that of the family. Working as a presenter for Winnemucca and Nevada Dementia Friends, I have come to believe that by addressing the terms, defining them, and then guiding family, friends, and my community to a better understanding, we will be better educated, enriched, and prepared to assist those in need.
A dementia friend supports:
Health care that promotes early diagnosis and uses dementia care best practices along the continuum;
Businesses that offer informed services and environments for customers and employee caregivers;
Dementia-friendly public environments and accessible transportation;
Residential settings that offer memory loss services and support;
Dementia-aware and responsive legal and financial planning;
Caring communities of faith, first responders, law enforcement, and government services

Winnemucca is working to measure up to each of these standards - how well informed and progressive is your community?

Surviving an Alzheimer's Diagnosis

First, be certain that the diagnosis is correct. Trained neurologists or gerontologists can provide the best information after a thorough examination. If indeed, the problem is Alzheimer's make certain that your legal and financial matters are in order - clarify now so that difficulties can be avoided in the future. Find out about all of the health and social services available and then take full advantage of these.
Continue a good relationship with your attending physician. If your doctor is too busy to listen, it may be time to search for a new one. Support is so important.
Remember - and remind yourself periodically - that you are not alone. Begin attending a support group or use telephone and online services. Talking with others really is beneficial.
And as much as possible, remain positive. Find the goodness and calm in the present. You are important, valuable, and deserve dignity and respect.

Emotional Relationships and Dementia

Alzheimer's and other dementias slowly rob an individual of the power of emotional regulation. Roles as parent or spouse change irreversibly and you, the caregiver, are quite likely left with feelings of loneliness, helplessness, and betrayal. Grieving after death is accepted as natural; grieving during painful cognitive decline is often not realized as a natural part of losing one we love over months and years. Anger and denial may fill the void of a diminished relationship; blame and depression may also result. The happy retirement disappears as full-time caregiving fills your life.
And then, of course, guilt waltzes in to destroy the last shreds of confidence. "If I had only been kinder, more patient, more understanding, more..." Often you cannot hold these behaviors accountable because this frustrating loss is so long, debilitating, and devastating. A support group can help; a counselor can ease pain; good friends (who listen and do not advise) can make a difference as tough decisions must be made. Should this surgery take place? Would Dad be happier in a daycare setting instead of home alone? Would Mom prefer long-term care over the tangles and fights that currently ensue?
As for the caregiver, there is life beyond and after Alzheimer's and other dementias. There are assistance programs and ideas for your future available through family, friends, support groups, and the Alzheimer's Association. Do not be afraid to seek assistance and to receive support.

Adding to Your Coping Portfolio

Patience can wear thin when caring for someone with Alzheimer's disease or other dementias. It is important to remember that your loved one is doing the best he or she can while living with confusion and disorientation. Although it may seem like some of the troublesome behaviors are intentional - just to get your goat - these are rarely on purpose. You must just grin, take a deep breath, and become realistic with expectations. Much of these strange occurrences are simply out of your loved one's control. They seem to just pop up out of the blue.
Think about it. Imagine forgetting where you are going, where you have been, and why you considered either. Easy tasks can become insurmountable - getting dressed, preparing a bowl of cereal, using gadgets like microwaves and washing machine. Think of the insecurity, the emotional stress. In fact, sometimes if you watch carefully, you will note that some of your loved one's actions are reactions to your attitude and demeanor.
And so it is you, the caregiver, who must change. As abilities become limited, you'll need to alter your expectations and reactions. A routine can help. Sameness provides security. Get up at the same time, have clothes pre-laid out for easy access and dressing, have simple selections for meals. Make tasks simple. Instead of, "Here. Get dressed!", hand out items in the right order for getting dressed and in the correct orientation. If, even through the best planning, the socks are forgotten or the shirt is on backward, live with it for today and avoid confrontation or anger. Tomorrow gives you another chance.

How to Cope with Alzheimer's Disease

     Alzheimer's is a progressive disease with no reversal, no prevention, and no cure. With those horrible words being read, you can now focus on the future. That is one of the greatest challenges of facing such a terrible disease. You want to be certain - or as certain as possible - that your diagnosis or the diagnosis of a loved one is correct. Sometimes things like a UTI or a contra-indication from a prescription can create behaviors similar to dementia. Who ever thought that a urinary infection would be a relief? But we know that that is far better than hearing the words, "Alzheimer's disease".
     The process of Alzheimer's disease is unpredictable. While functional abilities begin to fade, there will be moments when everything seems just fine. The forgetfulness appears as a bump in the road. Although change in function and behavior are inevitable as the disease progresses, the timeline is unpredictable. The important thing to focus on is changes that present potential danger (driving or leaving a stove burner on high), wandering into unknown/unsafe places, or becoming violent. These may force you to think about getting additional assistance and no longer living alone.
     But there are many things that someone with Alzheimer's can still do during these slipping away stages: take a walk, help with daily chores, travel short distances with the family, play simple games, and definitely laugh and feel love. Learning to cope with decline is essential.

Dementia Friends

After a wonderful information session with Dolores Cox, the Dementia Friends information team is rolling. The 5 members include Robin Gillis, Keeli McClintick, Sharon McAllister, Cary Walter, and Gini Cunningham. The last 4 held their first session Tuesday, June 19th, at the Pleasant Senior Center in Winnemucca. 7 attendees are now deemed "Dementia Friends". With this completed, the team is raring to go on more community events.
Following the information session and question and answer period, each attendee received their certificate of completion, a decal with Dementia Friend - Nevada for car or shop window, and a lovely bag of Keeli's delicious home-baked cookies.
Patty Ellifritz who was in attendance provided our team with matching t-shirts with the saying: Proud to Be a Dementia Friend. Way cool!!

Oh! My! Time Flies

It seems like I have been on a consistent blogging mode - trying to get something in every week, and then I realized that it has been 5 weeks since my last post. That is no good. So for a couple of updates:
Respite Retreat continues to be a boost for the community. Although our numbers are low, we know that this respite opportunity for caregivers will grow over time as word spreads about this wonderful twice monthly break. We always start with a project such as painting, coloring, creating home decor, or arranging flowers. This is often followed by music and singing or just interconnected conversation. We toss in a game like gin rummy or Yahtzee, games that are usually well known and fairly easy. We conclude with more conversation and plans for our next session. Two hours zips by in a flash.
We are now meeting the 1st and 3rd Monday of the month from 10am-noon at the Winnemucca Boys and Girls Club. This location has a wheelchair ramp right by our door and our gathering spot is quiet and secluded - ideal for our venture.
Please join us!!

Respite Retreat

To meet one of the goals set for Age- and Dementia-Friendly Winnemucca and Humboldt County we organized "Respite Retreat". This 2-hour break twice a month permits a loved one with Alzheimer's or other dementia to enjoy laughter, games, crafts, and music while the caregiver can run errands or just sit back and rest. In fact, often the caregivers joins us. Being a caregiver can be very isolating and so it is fun for these individuals to join in adult interaction and conversation.
It was difficult to find a place that would allow us to hold our Respite Retreat. Staying completely away from the words "adult daycare", we avoided all of the ramifications and rules that come with it. Ours is just a retreat, a time-out, a time-off, a chance to regroup and have fun. Stating liability concerns, however, our local hospital refused us as did the senior center. Fortunately, the Boys and Girls Club of Winnemucca said, "Yes!" and so we are off and running.
With a simple sign-in form that includes contact and other pertinent information we also include a "Permission to Use Photos" section. What better way to advertise and promote than with photos? We are also taking pictures of each art project that will later be transferred onto notecards that we can sell or give away to let people know of this special project.
The City of Winnemucca, hearing about our retreat endeavor, has approached us about adding a 1-hour walk/swim session at the local pool. While we have had no takers so far, that will not deter us from pursuing this possibility. Activity stimulates the brain and the mind. A trip to the pool may prove to be an excellent option.

Respect - Age- and Dementia-Friendly

Respect is so important to every one of us. Whether it is respect by family members, friends, the boss, co-workers, or just the occasional wave from a neighbor, we all like to feel like we are valuable, that we have worth. This is absolutely true of those with Alzheimer's disease and other dementias.
One of the first steps in developing respect is education. Those with Alzheimer's and other dementias have not wished this upon themselves. They did not "catch" it through risky behaviors. They did not check out a menu with an array of illnesses and say, "That is perfect - just what I want for the end of my life."
You may scoff and wonder who would think such nonsense, but many people do. Many people think that diminished cognition is contagious and so they stay away, avoid contact, deny that a loved one or a friend has a problem, most often an incurable one. That is why education is so essential. Instead of running and hiding, good family members and friends reach out with kindness and understanding. By this I do not mean pity. I don't believe anyone enjoys being pitied.
I mean true respect that includes conversations, even when they are confused and make little sense. I mean trips to the store, even when the trip is not simple. I mean treating an individual as the wonderful strong, unique person that is still there, maybe disguised or masked by wretched forgetfulness, but an individual who deserves constant and on-going respect - forever.

Social Inclusion Means Everyone

While we had lots of plans for helping people become actively involved in our community, we also knew that there was one area in which we were lacking: social inclusion for those with dementia, respite so that the full-time caregiver might enjoy a reprieve. Thus Respite Retreat came to fruition.
I had thought and pondered and asked about places to hold this for several years, but was struck not only by the overwhelming task of it all but also finding a place willing to host us. Both the hospital and senior center were open for meetings but they feared the liability that the day care scheme might create. I never could quite understand their fear as anyone of any age and any cognitive level can trip or fall or get scraped. Liability is not isolated to someone with dementia.
At last, after a wonderful conversation with the director of the local Boys and Girls Club, we found a home. Twice a month for two hours caregivers can drop off a loved one knowing that kind and tender caregivers will offer a good time. One of the best surprises in the planning came from the positive reception of our local RSVP (Retired Seniors Volunteer Program). Not only were several members willing to help, they actually arrived. Those of you who have planned and counted on others only to be disappointed know exactly what I mean.
For two hours, loved ones play games, sing, create crafts, chat, and flourish. Those in charge for the day have just as much fun as the one being cared for and we all leave enriched. After filling out minimal paperwork, the caregiver is free to run errands, take a walk, or go shopping, but it seems most like to dash away and return quickly so that they too can join the project and conversation of the day. Respite Retreat has been so rewarding.

Social Inclusion and Participation

There are several items that are essential to aging well: good food, exercise, cognitive stimuli, and social inclusion and participation. Everyone likes to feel like s/he is a part of something, whether it is the daily meal at the senior center with friends, a drive into the mountains with a sibling, or just hanging out. Age- and Dementia-Friendly Winnemucca has closely studied what we already have to offer in our community and we have also asked, "What else would you like?"
Well, most responses to the latter happened to be activities that already exist, like book clubs, crafting groups, and card clubs. We realized that an important step in promoting social inclusion and participation required that we advertise events better.
Between excellent connections and publishing with our local newspaper, contact with our two radio stations, adding messages to the downtown marquee, and producing a booklet with contact information and event calendar, we feel like we have really reached out to help others become aware of what's happening, when, and where.
We also wanted to get more particular about just what it was people really wanted and what each group had to offer. For example, are folks interested in fiction or non-fiction as far as book clubs are concerned? Does the crafting group greet everyone with open arms, even those who are "crafting challenged"? As for the card club, are members accepted who have some cognitive decline? Is each group patient and helpful? Does each group welcome new participants? And really, are any of these groups well suited to anyone regardless of age, mental cognition, and perhaps a handicapping condition? Some exploration is needed.

Housing - Continued

While we have our list ready for contractors and realtors, we also realize that we must remain vigilant to ensure that our message is being heard and our ideas implemented. Too often others make choices for us - like housing amenities - without really consulting to find out what we really want and need to have in a home.
Fortunately, we live in a safe community with strong police and sheriff departments. Members of each staff look out for residents, whether with an occasional check-up visit when there is fear that a resident might wander or just have trouble living alone or a drive-by scan when someone is off on vacation to make sure that a home is fairing well. This is a bonus to local housing.
We also have many parks in our neighborhoods as well as some good sidewalks and walkways. Again, we will continue to work on improvements so that everyone who lives in our community has good access to outdoor spaces and recreational areas.
We have several excellent housing opportunities for those who like to live in apartments or duplexes, especially those that include no maintenance of yards, driveways, or sidewalks. One of the best is Larios Arms, a multi-storied building complex located right next to the senior center. Residents can trot on down for lunch, crafts, and exercise then return home in a flash. Good neighbors here look out for one another making this residence even more inviting.
Just up a long block from Larios is the Community Garden. Many people have small plots within the garden for a vegetable or flower patch. Another goal of age-friendly will be to make this garden even more lovely and accessible: paved pathways, a rose garden, tables and benches in the gazebo, and raised beds. Sounding mighty fine!

Age-Friendly - Housing

After tackling transportation needs and outdoor spaces, the Age- and Dementia-Friendly Winnemucca Project Team discussed housing. Even though Winnemucca is a small city, housing here is quite expensive. With gold mines flourishing there is a huge demand for new, upgraded, larger homes, which are super for those with good salaries, but tough for people on a fixed income. Many seniors would like to "downgrade" their homes, or at least make their current homes more compatible with aging.
Downgrading refers to finding a smaller, more convenient and efficient home. Many older individuals no longer need (or want) a sprawling 3-4 bedroom home with multiple bathrooms to clean, bathrooms that do not have grab bars and other tools that are helpful for navigating these spaces. Smaller homes are difficult to find here - there is far more money to be had in large homes squeezed onto small lots, than there is in smaller homes, even multi-family complexes. Part of the task of the Project Team has been to inform contractors and realtors of many of the facets that make a home perfect for aging in place.
Some home accoutrements include:
large, easy to grasp handles on all cabinets
lever door knobs for easy manipulation
lever door knobs that when locked do not push down (saves getting locked out or having a wanderer disappear out of the front door)
door hinges that expand for easier access for moving, or for wheelchairs or walkers
single story homes so that stairs are eliminated
some lower counter spaces so that someone in a wheelchair or who needs to be seated to work has easier access
smooth floors for easy of movement (but not slippery surfaces)
elimination of frayed carpet and/or multiple area rugs that can cause tripping
grab bars in showers and tub areas and by toilets
higher toilets for ease of sitting and rising
easy-reach lighting
well-lit areas both inside and outside of the phone
There are many more suggestions. I can forward additional information to you if you send me an email or you can also go online and visit our website www.adf-winnemucca.com or the AARP website. Search: HomeFit.

Rounding Up Outdoor Spaces for Age-Friendly Project

So back to the sidewalks. The Age- and Dementia-Friendly Winnemucca Project looked at the cracked, crumbling, or non-existent sidewalks throughout our community and made some recommendations to the CityCouncil, however, sidewalks are expensive, not budgeted for this fiscal year, and so the sidewalks were set aside for now.
Instead, we studied existing sidewalks in good repair and decided to create some large, weather-proof maps, to place around town in strategic spots. These maps will include sidewalk routes and trails including distances that are already available. At some points along the routes the sidewalks disappear and so we will have a pedestrian area marked alongside the road. At least it is a start.
Many out-of-town guests are not aware of the fantastic trails we have just outside of town for walking, running, or biking. Our maps will really give them a heads-up on some of the wilderness trails that are also close to town with easy access and lots of parking.
And why such an emphasis on outdoor spaces? Being outside is good for the health - whether walking, talking, or just enjoying the view, the out-of-doors is inspiring. Often when people visit a park or other outside areas, they are also with friends. Friends mean socialization and socialization is excellent for good health. Not only does it stimulate brain activity - talking and thinking and reflecting - it also advances emotional well-being. Friendships make such a difference in positive, personal outlook.

More on Outdoor Spaces...

While sidewalks all around our city are an enormous task that will require lots of money and hard work, it is a doable and necessary project. Little by little we will chip away at the barriers that prevent better walking areas and then see them installed. Time and patience - two words with which we will become very friendly.
Another big and wonderful project was the installation of benches and game tables throughout our community. Often when you go to a park or trail, there are benches with no backs or simply no benches at all. If a person plans to spend some time at the park, visiting, picnicking, or watching kids play, backs get tired without support. This gave the Age- and Dementia-Friendly Winnemucca Project a goal: benches with backs placed strategically around town.
Good, sturdy benches are pricey. Even though we ordered 10 in bulk, with the same Winnemucca Centennial logo on the back, each came to total of $1266. But they are beautiful. The game tables are equally as gorgeous - polished red or tan granite with a checker board/chess board game table etched into each (and also very expensive!). We had these designed with a stool on opposite sides, leaving room for wheelchairs or lawn chairs on the other two sides. The tables and benches can now be found in our parks, along the Haskell Street walkway, and you'll even spy a table and a bench in Denio, Nevada, a community 100 miles northwest of Winnemucca. As Denio set to open its new library, we thought how perfect! A bench and a table for a wonderful grand opening in one of our rural towns.
The biggest problem with the tables and benches - and one that I learned the hard way? Payment. I had people stop me on the street, grab me aside at meetings, call me on the phone, and send email requests: "Please order a bench/table for me/our family!" A believer and one who complies, I ordered these and then surprise! Some folks had changed their minds and no longer wanted to invest in our project. As a result I scurried about town, made phone calls and pleas, and also tossed extra cash into the kitty to pay our bill. Again, lesson learned: "Show me the money!" before I will order even the simplest item.

Outdoor Buildings, Structures, and Spaces

The second area that Age- and Dementia-Friendly Winnemucca studied was our outdoor buildings and spaces. Are they accessible? Is there adequate seating for all individuals (those with wheelchairs, walkers, strollers, etc.)? Are there enough handrails? Is there good lighting? The questions go on and on and inspection of our spaces provided us with excellent insight and guidance.
If buildings and structures are related to the government, they are naturally up-to-code and sometimes they are even beyond code such as pedestrian crossings that have audio as well as visual capacity. Other buildings and structures, may not be up to code as they have been "grandfathered in" or are not required to comply with accessibility rules. That is where education becomes so important.
For example, sidewalks. We have lots of sidewalks throughout our city, however, some are in disrepair. Some run in front of one building or home and then not the next making for difficult walking. As a homeowner, I can decide to get the sidewalk fixed at a fairly minimal cost, especially if I am fit enough and have a friendly work team to help me get the job done. With city sidewalks, though, there are requirements for width, depth, design, and so forth, and thus some sidewalks are in a shambles. Making businesses aware of this (as if they did not already know!) was one project goal; the second was informing the city of our project team concern.
Of course, repair all boils down to funding and it seems government entities are always short of cash. Our job then became to remind and remind and remind the city council and others how important good sidewalks are to a livable, walkable community.
Slowly, the idea is brewing. Requirements for new homes include sidewalks and it is the hope that when neighbors see these lovely sidewalks, they will want one, too. That's a start. The second is designating walkways for exercise, fitness, and fun. One of these is from Larios Arms, a senior living community, to the Community Garden. Inside the garden we are planning a circular walkway as well. Simple, doable, and important.
The second walkway project is bigger and will include an exercise pad. Pads are expensive so lots of talking and legwork are in order. But with an idea and a plan, I know we will achieve success.

Transportation Ideas to Implement in Your Community

The first steps for Winnemucca in our discussion about transportation was to run a survey: what's available; when is it available; is there a cost; where does it go; what else do riders need to know?
We learned that the Senior Center bus runs Monday through Friday during business hours and that riders can go just about anywhere in the city for a nominal fee.
One problem includes the fact that riders must be able to get out to the curb by their homes for the bus to pick them up and when they exit the bus, they need to be able to navigate on their own.
Of course, many who want to ride the bus have limited mobility. They cannot meet at the curb as, for example, their sidewalk is steep and has cracks, the wheelchair and/or walker are difficult to manipulate, in climate weather makes waiting outside for the bus hard, and so getting to and waiting at the curb become impossible.
Our solution: A concierge service assists riders. Seniors can phone the senior center to learn when the "Concierge" will be riding the bus. The Concierge helps with entry and exit as well as helping the individual into his/her home.
Another problem: Riding the bus to downtown shops and then finding that there are no parking spots for the senior bus to pull over and load or unload passengers. The bus cannot block traffic and passengers cannot just be set free in the street.
Our solution: An accessible space large enough for the bus has been designated downtown so that now the bus can park in a convenient spot for all passengers.
A third problem: Insurance rates for cars are expensive plus as drivers age, some of the rules-of-the road have changed or have been forgotten.
Our solution: A volunteer who became a trained instructor with AARP teaches the fundamentals class, helps seniors review critical driving topics, and assists those who have completed the course to report it to insurance companies for a small discount in the rate.
Finally, we faced letting everyone know about all of the wonderful services offered in Winnemucca and Humboldt County.
Our solution: We created a booklet full of pertinent information, we added a monthly blurb in our local newspaper about services and upcoming events, we worked with our local radio station to disiminate information, and we had a website designed: www.adf-winnemucca.com

Back to Age-Friendly - Transportation

The last few posts have focused on de-stressing - if that is truly possible in our very busy lives. Knowing that stress leads to many mental and physical health problems, addressing it is of absolute value. Hopefully with your planner in order, with notes marking every item as Vital, Important, Tabled, and Eliminate, some free time should have been freed up and some stress should have been de-stressed.
Age-friendly communities focus on creating a perfect environment for every individual, regardless of age, physical or cognitive challenges, or health issues. Good facilities with good homes along with good activities and opportunities make for a good community.
Winnemucca and Humboldt began the age-friendly pursuit over two years ago and we have made tremendous progress. Beginning with driving and dementia, the team realized that taking a driver's license away is not a solution. In fact it may aggravate a problem. As a result our team investigated the various means of transportation in our community and then got the contact information into the hands of those who need it. We surveyed and then added:
1. an accessible parking space large enough for the senior bus in  busy, downtown shopping area;
2. a concierge service to help those in need when traveling on the senior bus;
3. a trained, AARP driver's education instructor to help seniors review keys points of driving to help them always drive with due care;
4. advertisement about the diverse means of transportation in our community: senior bus, veteran's services, RSVP services, NET driving services, and taxi services are several of these.
We are fortunate to have a community that cares and is ready to remedy transportation problems.

Important Is Under Control; Let's Move to Table and Eliminate

Every step along the pathway to clearing up unwanted and unnecessary stress is of absolute value. The Do-It-Now stuff simply has to be done. These are VITAL to your success and well-being. Remember that if one of these tasks can be complete in 1-2 minutes and you have 1-2 minutes at hand, take care of it now. It is such an empowering feeling to recognize a vital task, address it, and solve it. Voila! And even better is the swift crossing of this off the list with a wild, carefree line.
Other VITAL items require more time and so should be scheduled into your planner with the appropriate time allotment slotted, plus half that time again. Most VITAL tasks take more time than you are planning on so this way you have already planned ahead AND you can achieve success with this VITAL item. Another cross-out is coming your way.
IMPORTANT items need to be completed, but they are not immediately critical. Thus you have time to step back, study your schedule, and then jot them into the planner. The most valuable step in completing these items is when the appointed time arrives, just do it! Do not wait, move, table, or ho-hum it. Take care of it now.
So now comes two of the best, most invigorating stress relievers - TABLE it because it is just not that important; and even more fun - ELIMINATE it. On the latter, you probably did not want to do it in the first place and now you have the extreme pleasure of tossing it into a garbage forever! Hurray. This elimination process may happen with TABLEd items as well. If the tabling time arises and you have no desire to see it through - chuck it with crazy abandon and be done.

Moving to What's Important

I trust that you have attended to all of the VITAL items in your planner - bills to pay, phone calls to make, meetings to attend, cookies to bake - all of the absolutely must do responsibilities that pile into life. This may also include the 1-2 minute items that I mentioned in my last post. These are must-dos that can be put off, but since they are a quick fix, it is best to take care of them now during a pause,  while you remember them and also so that you can cross them off the to-do list. Crossing off is a powerful, empowering physical and mental movement.
Now for the items on your list that are IMPORTANT. You must do them, need to do them, are going to do them, however, they are not immediately essential. Tomorrow works and so does next week. This might be a bill coming due, an assignment to complete, or a part of the house or garage that needs cleaning up or repair. If they are on the IMPORTANT list, they must be done in a timely manner, just not so soon or in such a way that the crunch gets the best of you. If you discover that you are putting these tasks off again and again, it is time to re-evaluate the significance of the item. Is it really important, a must do? If so, immediately relabel it VITAL. If can it be shuffled to the the TABLED section of your planner, do so. Paying property taxes might fall into this latter category - they are vital, and important, but taxes come due at varying intervals throughout the year. If you just paid in March, the next taxes are not due until August so you have months before payment comes due. Take a breath - July is ample time to get this critical tax paid.
The next blog will compare IMPORTANT and TABLED, the value of each and the pitfalls that you might incur. For today, examine the IMPORTANT items of this week, determine when and how you will accomplish each, and solemnly swear just get them done.

VITE! Vital Things to Take Care of NOW!

Vite is the command "Fast" in French. Vite, vite, vite - hop to it. That is one reason the V in Vital is so valuable. If it's got to get done, do it now. Do not wait or hesitate, attend to it so that you can check-mark it off the list and move on to other important tasks.
A few years ago my niece recommended that I read The Happiness Project. Being obedient, and figuring I might gain terrific insight, I obeyed orders and read it. Far from making me happy, this book just irritated me. The advice may have brought joy to some, but for me it was sheer frustration. Frustration, that is, except for one small part. Basically stated, this section of the book explained tiny projects or responsibilities, those that can be completed in one or two minutes. For example, tomorrow is garbage day, I know it is garbage day, I plan for garbage day so that all of my toss-outs are assembled and ready for disposal. As I am walking down the stairs I spy a garbage bin that I have inadvertently missed. I am confronted with 3 choices:
1. Ignore it - I can always throw it out another day;
2. Make a note to self - "Next time you walk by, grab that trash and get rid of it;
3. Attend to it now - This is a 2 minutes or less job and if I take care of business now, I will not have to come back to it later. Case closed; responsibility completed.
And in less than 2 minutes, this vital job is dispensed with and done for a day or two, or maybe until next garbage day.
Return to your planner today. Think about all of the projects that you have marked V - Vital. Circle the ones that can be completed in 2 minutes or less and have to, heave ho, go for it! Perhaps this will bring you happiness, or at least an inkling of success.

You should be feeling pretty powerful this morning. You have given yourself a quick once-over as to what may be your triggers for stress, you have practiced saying "No" to a number of people and in a number of situations, and you have started to organize your daily planner. 3 super accomplishments!
With that planner, have you been able to incorporate VITE? Vital - got to attend to; Important - but it for a few hours, days, or weeks; Table - let it simmer and re-evaluate later; and Eliminate - I simply do not need or want to do this.
As I refocused on my planner, implementing this acronym, I started to see blank areas begin to appear in my otherwise stuffed calendar. VITE clarified what I want to do, where I want to be, and with whom I want to spend time. Very helpful. I had to admit to myself, that some things that I'd like to eliminate, I can't. I'm already midway through some projects and to drop them now would not be fair to the rest of the stakeholders. But with a new focus I will be able to avoid some of these time-and-energy-sucking projects.

Yesterday's advice concerned saying "No". How are you doing? No is a very tough word to incorporate into your vocabulary when you have always been the go-to, yes-person at home, with your family, at work, in clubs and organizations, in life. Most people, especially women, are pleasers. They like things done right; they like things done on time; they like people happy; they like life organized. And what is the best way to accomplish all three? By taking charge, by agreeing, by saying, "Yes".
Yes is certainly an OK word - what would we do if no one every offered to help or to lead? Matters would be continually at loose ends, with little or nothing ever been completed. Now that would be no fun. However, Yes can also be exhausting, and unless you have a planner and are jotting down your calls to duty, it is easy to overbook, over-offer, over-do-it. And that just leads to stress.
So after practicing saying the word "No" (yesterday's assignment!), my second advice is get a planner. If you already have one, fill it out; if you have already filled it out, it's time to check it over to see what items are vital, important, able to be tabled, and what needs to be eliminated. Just reading through, purging, and prioritizing is a powerful step.

Again, your 4 labels for your planner:
V - Vital (must do/must complete/must have; these things keep you awake at night because of their value, however, when the day dawns, sometimes they are forgotten and/or shuffled to a back burner. Attend to them now).
I - Important (must do, but it does not have to be today. Paying bills might be such an item - you have to do it, but since payday is not until next week, this can wait).
T - Tabled (it's got to be done or planned for but the due date is down the road weeks or months from now. Set it aside, but if it is Important or about to become Vital, do not let this responsibility slip away. If it is due in June, move to May on your calendar and jot this item down as a reminder).
E - Eliminate (it isn't that important and really, who cares?).
VITE - that's life! Enjoy it as you de-stress and re-organize.

De-stressing to Enhance Mental Cognition - Saying "No"

While there are many roads that may lead to Alzheimer's disease and/or other dementias, there are also many ways to detect a different underlying cognitive problem, one that can be "fixed", so to speak. From my observations, probably the biggest impact on cognition for those 20-60 years of age, is stress. We are running left, right, up, and down to solve, attend to, manage, balance, and survive. Whether self-imposed (the most likely) or imposed upon, we tend to think that we have to do and be everything to everyone at all times.
A first step to de-stressing is learning to say, "No." It is also the hardest step. If you are a pleaser, or you just like to see matters taken care of efficiently and effectively, this "No" word is difficult. Having a vision, recognizing how you want things to unfold, saying "No" puts someone else in charge. So, yes, you have some freedom now, but you all have to settle for having things completed (or left undone) in a fashion of which you do not approve. And if your name is on the package as part of the "set-up" or "put-together" team, this can be unnerving as well as discouraging.
Plus when you have responded "Yes" to every request, it is hard for others to know what to do when you do say "No". Most often these folks do not realize how hard it is for you to utter this word, and how even harder it is for you to follow through. People get around you by saying, "Well, if you will not chair this production, with all of your talents and insight, will you please assume the role for Part B? We need you."
Flattery or truth, saying "No" now may be even harder. It is important to accept that saying "Yes" at this point also means loosing control of certain aspects as someone else is now in charge. Without a doubt, you are even more stressed with the situation. After all, things will probably not roll out to your liking.
This is just part of the reason saying "No" and sticking to it is amazingly difficult - nearly impossible.
Your homework, then is to list your responsibilities (please stop at 10), and then analyze them as to significance and value. This could take quite some time but it will be worth it as you develop your "No" abilities.
On the side, as you work on your list and analysis, practice saying "No" - just that 1 word to begin with and later we will work on adding your reasons/reasoning why.
Happy "No" Day to You!

How is your mental cognition?

As we age we tend to forget things. Sometimes this is good as harboring bad feelings hurts the body and the soul. But at other times we forget things like where they car keys were placed, how to perform a specific function on the computer, or easy directions to a familiar location. What does this mean? Well, only a thorough examination by your neurologist can tell - and then maybe not. An exam can uncover problems with medication,  an infection, or stress. So current forgetfulness may be completely insignificant or better said, rectified simply.
As we age, some medications react differently, so that prescription taken for 20 years may now be ineffective or problematic. It is amazing the number of times that cognitive problems radiate from an infection - especially UT. It is rather routine for people to breeze on, ignoring warning signs of infection, while feeling absolutely miserable. However, once a prescription comes into play, life (and mind) return to normal.
One of the biggest trials we face is stress. Americans, especially women, are stressed. (And I believe this stress and women part is true worldwide). Women carry tremendous expectations for caring for family, working outside of the home, balancing 192 activities, and remaining pleasant, affable, and concerned with every aspect of life. Many of these expectations are self-inflicted - the desire to be perfect - while others are placed on us by society.
Do you find yourself floating in the stress boat, seeking a paddle or lifejacket to guide you safely to shore? Stay tuned for some insight on de-stressing your life. Or perhaps you have some advice for me.

What is age- and dementia-friendly?

What is more important than living in a safe community that has everything to offer from the day you are born, throughout your life? That is what age- and dementia-friendly is all about. With a survey (or 4-5) take the time to learn what your community already has, what needs to be adjusted, and what you need to add. That's what Winnemucca did and we are up, running, and excited to unite with like minded individuals across Nevada, the US, and the world.