Welcome to Healthy Corner!


As we age, we all want to stay healthy. However, staying healthy requires more than having a good nutrition. It also involves regular physical activity, maintaining a healthy weight and more.

Healthy Eating

Information provided by the USDA at
www.ChooseMyPlate.gov/adults

Men And Women

Adults of all ages have different nutrition and physical activity needs as their lives and bodies change. A strong and healthy body can provide many benefits. As you age, maintaining healthy habits is an important way to lower your risk for cancer, diabetes, heart disease and hypertension. Make your food and beverage choices a priority and be physically active to feel and look better.


Eat A Healthy Diet

Fruits, vegetables, whole grains, and fat-free or low-fat dairy products are healthy choices. Include protein foods such as poultry, fish, beans, eggs, nuts and lean meats. Choose foods that are low in saturated fats, sodium, and added sugars.

Be physically Active

Jogging, playing team sports, and biking are just a few examples of how you can get moving. Start small and work up to 150 minutes of moderate-intensity physical activity per week if you are not already physically active.


Know Your BMI

Knowing your body mass index (BMI) can be an important first step in adopting a realistic diet and physical activity plan to help you get to and maintain a healthy weight.


Stay at a Healthy Weight

As you age, manage your calories to stay at a healthy weight. This will prevent gradual weight gain over time. Balance the calories you take in with the calories you burn through physical activities. Periodically track what you eat and drink as well as your physical activity to keep you focused. Use online tools available on your phone, tablet or computer to accurately monitor your food and physical activity. Use the daily food plans below to find out how many calories you need to maintain or achieve your goals.


Older Adults

Healthy Eating As We Age
As we age, healthy eating can make a difference in our health, help to improve how we feel, and encourage a sense of well-being. Eating healthy has benefits that can help older adults:


Nutrients

  • Obtain nutrients needed by the body such as potassium, calcium, vitamin D, vitamin B12, minerals, and fiber.
  • Lose weight or maintain a healthy weight
  • Reduce the risk of developing chronic diseases such as high blood pressure, diabetes, hypertension, and heart disease.If you have a chronic disease, eating well can help to manage the disease.
  • Meet individual calorie and nutrition needs.
  • Help to maintain energy levels.

  • Special Nutrition Concerns for Older Adults

    Our daily eating habits change as our bodies get older. Make small adjustments to help you enjoy the foods and beverages you eat and drink.


  • Add flavor to foods with spices and herbs instead of salt and look for low-sodium packaged foods.
  • Add sliced fruits and vegetable to your meals and snacks. Look for pre-sliced fruits and vegetables on sale if slicing and chopping is a challenge.
  • Ask your doctor to suggest other options if the medications you take affect your appetite or change your desire to eat.
  • Drink 3 cups of fat-free or low-fat milk throughout the day. If you cannot tolerate milk try small amounts of yogurt, butter milk, hard cheese or lactose-free foods. Drink water instead of sugary drinks.
  • Consume foods fortified with vitamin B12, such as fortified cereals.

  • Be Active Your Way

    Focus on maintaining a healthy body weight. Being physically active can help you stay strong and independent as you grow older. If you are overweight or obese, weight loss can improve your quality of life and reduce the risk of disease and disability.


  • Adults at any age need at least 2 ½ hours or 150 minutes of moderate-intensity physical activity each week. Being active at least 3 days a week is a good goal.
  • Find an activity that is appropriate for your fitness level. If you are not active, start by walking or riding a stationary bike. Strive for at least 10 minutes of exercise at a time and be as active as possible.
  • Include activities that improve balance and reduce your risk of falling such as lifting small weights. Add strength building activities at least 2 times per week.
  • Being active will make it easier to enjoy other activities such as shopping, playing a sport, or gardening.
  • If you are not sure about your level of fitness, check with your doctor before starting an intense exercise program or vigorous physical activity.

  • Resources for Older Adults

  • Choosing Healthy Meals as You Get Older
  • Download PDF

  • Healthy Eating After 50
  • Download PDF

  • Go4Life from the National Institute on Aging
  • - See more at https://go4life.nia.nih.gov/mygo4life

  • What's On Your Plate? Smart Food Choices for Healthy Aging
  • - See more at https://www.nia.nih.gov/health/publication/whats-your-plate

  • MyPlate for Older Adults
  • - See more at http://www.choosemyplate.gov/older-adults

  • How Much Physical Activity Do Older Adults Need?
  • - See more at http://www.cdc.gov/physicalactivity/basics/older_adults/index.htm

  • Benefits of Exercise
  • - See more at http://nihseniorhealth.gov/exerciseforolderadults/healthbenefits/01.html

    Am I Moving Enough?

    Information provided by the CDC at
    www.cdc.gov/physicalactivity/basics/adults/

    How Much Physical Activity Do Adults Need?

    Physical activity is anything that gets your body moving. According to the 2008 Physical Activity Guidelines for Americans, you need to do two types of physical activity each week to improve your health–aerobic and muscle-strengthening.

    For More Important Health Benefits
    Adults need at least:
    Walking Jumping Jacks 1 Squats Aerobics 1

    2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and

    muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

    Or, Running Stationary Bike 1 Push Up Sit Up 1

    1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week and

    muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

    Or, Step Aerobics 1 Stationary Bike 1 Squats Walking

    An equivalent mix of moderate- and vigorous-intensity aerobic activity and

    muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

    10 Minutes at a Time is Fine

    We know 150 minutes each week sounds like a lot of time, but it's not. That's 2 hours and 30 minutes, about the same amount of time you might spend watching a movie. The good news is that you can spread your activity out during the week, so you don't have to do it all at once. You can even break it up into smaller chunks of time during the day. It's about what works best for you, as long as you're doing physical activity at a moderate or vigorous effort for at least 10 minutes at a time.

    Aerobic Activity – What Counts?

    Aerobic activity or "cardio" gets you breathing harder and your heart beating faster. From pushing a lawn mower, to taking a dance class, to biking to the store – all types of activities count. As long as you're doing them at a moderate or vigorous intensity for at least 10 minutes at a time.

    Intensity is how hard your body is working during aerobic activity.

    How do you know if you're doing light, moderate, or vigorous intensity aerobic activities? For most people, light daily activities such as shopping, cooking, or doing the laundry doesn't count toward the guidelines. Why? Your body isn't working hard enough to get your heart rate up.

    Moderate-intensity aerobic activity means you're working hard enough to raise your heart rate and break a sweat. One way to tell is that you'll be able to talk, but not sing the words to your favorite song. Here are some examples of activities that require moderate effort:

  • Walking fast
  • Doing water aerobics
  • Riding a bike on level ground or with few hills
  • Playing doubles tennis
  • Pushing a lawn mower
  • Vigorous-intensity aerobic activity means you're breathing hard and fast, and your heart rate has gone up quite a bit. If you're working at this level, you won't be able to say more than a few words without pausing for a breath. Here are some examples of activities that require vigorous effort:

  • Jogging or running
  • Swimming laps
  • Riding a bike fast or on hills
  • Playing singles tennis
  • Playing basketball
  • You can do moderate- or vigorous-intensity aerobic activity, or a mix of the two each week. A rule of thumb is that 1 minute of vigorous-intensity activity is about the same as 2 minutes of moderate-intensity activity.

    Some people like to do vigorous types of activity because it gives them about the same health benefits in half the time. If you haven't been very active lately, increase your activity level slowly. You need to feel comfortable doing moderate-intensity activities before you move on to more vigorous ones. The guidelines are about doing physical activity that is right for you.

    For Even Greater Health Benefits
    Older Adults Should Increase Their Activity To:
    Walking Jumping Jacks 1 Squats Aerobics 1

    5 hours (300 minutes) each week of moderate-intensity aerobic activity and weight training muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

    Or, Running Stationary Bike 1 Push Up Sit Up 1

    2 hours and 30 minutes (150 minutes) each week of vigrous-intensity aerobic activity and weight training muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

    Or, Step Aerobics 1 Stationary Bike 1 Squats Walking

    An equivalent mix of moderate- and vigorous-intensity aerobic activity and muscle-strengthening activities on 2 or more days a week that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).

    More time equals more health benefits

    If you go beyond 300 minutes a week of moderate-intensity activity, or 150 minutes a week of vigorous-intensity activity, you'll gain even more health benefits.

    Build up over time

    If you want to do more vigorous-level activities, slowly replace those that take moderate effort like brisk walking, with more vigorous activities like jogging.

    Muscle-Strengthening Activities – What Counts?

    Besides aerobic activity, you need to do things to strengthen your muscles at least 2 days a week. These activities should work all the major muscle groups of your body (legs, hips, back, chest, abdomen, shoulders, and arms).

    To gain health benefits, muscle-strengthening activities need to be done to the point where it's hard for you to do another repetition without help. A repetition is one complete movement of an activity, like lifting a weight or doing a sit-up. Try to do 8—12 repetitions per activity that count as 1 set. Try to do at least 1 set of muscle-strengthening activities, but to gain even more benefits, do 2 or 3 sets.

    You can do activities that strengthen your muscles on the same or different days that you do aerobic activity, whatever works best. Just keep in mind that muscle-strengthening activities don't count toward your aerobic activity total.

    There are many ways you can strengthen your muscles, whether it's at home or the gym. You may want to try the following:

  • Lifting weights
  • Working with resistance bands
  • Doing exercises that use your body weight for resistance (i.e., push ups, sit ups)
  • Heavy gardening (i.e., digging, shoveling) Yoga
  • What If You Have a Disability?

    If you are an adult with a disability, regular physical activity can provide you with important health benefits, like a stronger heart, lungs, and muscles, improved mental health, and a better ability to do everyday tasks. It's best to talk with your health care provider before you begin a physical activity routine. Try to get advice from a professional with experience in physical activity and disability. They can tell you more about the amounts and types of physical activity that are appropriate for you and your abilities.

    Managing My Stress

    DOWNLOAD PDF

    Information provided by NIH/NIMH at
    www.nimh.nih.gov/health/publications/stress/index.shtml/index.shtml

    Fact Sheet on Stress
    Q&A on Stress for Adults: How it affects your health and what you can do about it

    Stress — just the word may be enough to set your nerves on edge. Everyone feels stressed from time to time. Some people may cope with stress more effectively or recover from stressful events quicker than others. It's important to know your limits when it comes to stress to avoid more serious health effects.

    What is Stress?

    Stress can be defined as the brain's response to any demand. Many things can trigger this response, including change. Changes can be positive or negative, as well as real or perceived. They may be recurring, short-term, or long-term and may include things like commuting to and from school or work every day, traveling for a yearly vacation, or moving to another home. Changes can be mild and relatively harmless, such as winning a race, watching a scary movie, or riding a rollercoaster. Some changes are major, such as marriage or divorce, serious illness, or a car accident. Other changes are extreme, such as exposure to violence, and can lead to traumatic stress reactions.

    How does stress affect the body?

    Not all stress is bad. All animals have a stress response, which can be life-saving in some situations. The nerve chemicals and hormones released during such stressful times, prepares the animal to face a threat or flee to safety. When you face a dangerous situation, your pulse quickens, you breathe faster, your muscles tense, your brain uses more oxygen and increases activity—all functions aimed at survival. In the short term, it can even boost the immune system.


    However, with chronic stress, those same nerve chemicals that are life-saving in short bursts can suppress functions that aren't needed for immediate survival. Your immunity is lowered and your digestive, excretory, and reproductive systems stop working normally. Once the threat has passed, other body systems act to restore normal functioning. Problems occur if the stress response goes on too long, such as when the source of stress is constant, or if the response continues after the danger has subsided.

    How does stress affect your overall health?

    There are at least three different types of stress, all of which carry physical and mental health risks:

  • Routine stress related to the pressures of work, family and other daily responsibilities.
  • Stress brought about by a sudden negative change, such as losing a job, divorce, or illness.
  • Traumatic stress, experienced in an event like a major accident, war, assault, or a natural disaster where one may be seriously hurt or in danger of being killed.

  • The body responds to each type of stress in similar ways. Different people may feel it in different ways. For example, some people experience mainly digestive symptoms, while others may have headaches, sleeplessness, depressed mood, anger and irritability. People under chronic stress are prone to more frequent and severe viral infections, such as the flu or common cold, and vaccines, such as the flu shot, are less effective for them.


    Of all the types of stress, changes in health from routine stress may be hardest to notice at first. Because the source of stress tends to be more constant than in cases of acute or traumatic stress, the body gets no clear signal to return to normal functioning. Over time, continued strain on your body from routine stress may lead to serious health problems, such as heart disease, high blood pressure, diabetes, depression, anxiety disorder, and other illnesses.

    How Can I Cope with Stress?

    The effects of stress tend to build up over time. Taking practical steps to maintain your health and outlook can reduce or prevent these effects.
    The following are some tips that may help you to cope with stress:

  • Seek help from a qualified mental health care provider if you are overwhelmed, feel you cannot cope, have suicidal thoughts, or are using drugs or alcohol to cope.
  • Get proper health care for existing or new health problems.
  • Stay in touch with people who can provide emotional and other support. Ask for help from friends, family, and community or religious organizations to reduce stress due to work burdens or family issues, such as caring for a loved one.
  • Recognize signs of your body's response to stress, such as difficulty sleeping, increased alcohol and other substance use, being easily angered, feeling depressed, and having low energy.
  • Set priorities-decide what must get done and what can wait, and learn to say no to new tasks if they are putting you into overload.
  • Note what you have accomplished at the end of the day, not what you have been unable to do.
  • Avoid dwelling on problems. If you can't do this on your own, seek help from a qualified mental health professional who can guide you.
  • Exercise regularly-just 30 minutes per day of gentle walking can help boost mood and reduce stress.
  • Schedule regular times for healthy and relaxing activities.
  • Explore stress coping programs, which may incorporate meditation, yoga, tai chi, or other gentle exercises.

  • If you or someone you know is overwhelmed by stress, ask for help from a health professional. If you or someone close to you is in crisis, call the toll-free, 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).

    What Are Advanced Directives?

    DOWNLOAD PDF

    Information provided by NIA/NIH at
    www.nia.nih.gov/health/publication/advance-care-planning

    Advance care planning is not just about old age. At any age, a medical crisis could leave someone too ill to make his or her own healthcare decisions. Even if you are not sick now, making healthcare plans for the future is an important step toward making sure you get the medical care you would want, even when doctors and family members are making the decisions for you.

    More than one out of four older Americans face questions about medical treatment near the end of life but are not capable of making those decisions. This tip sheet will discuss some questions you can think about now and describe ways to share your wishes with others. Write them down or at least talk about them with someone who would make the decisions for you. Knowing how you would decide might take some of the burden off family and friends.

    Tips from The Nationial Institute on Aging
    What Is Advance Care Planning?

    Advance care planning involves learning about the types of decisions that might need to be made, considering those decisions ahead of time, and then letting others know about your preferences, often by putting them into an advance directive. An advance directive is a legal document that goes into effect only if you are incapacitated and unable to speak for yourself. This could be the result of disease or severe injury—no matter how old you are. It helps others know what type of medical care you want. It also allows you to express your values and desires related to end-of-life care. You might think of an advance directive as a living document—one that you can adjust as your situation changes because of new information or a change in your health.



    Medical Research and Advance Care Planning

    Medical research plays an important role in the health of Americans of all ages. Because of advances in medicine and in public health, Americans are living longer and staying healthier as they grow older. The National Institute on Aging (NIA) supports much of the research around the country that looks at how people age and how to improve their health in their later years. NIA is part of the National Institutes of Health (NIH), the nation’s medical research agency.


    Some NIA-supported research focuses on advance care planning, including examining why people might complete advance directives and the effect of these directives on end-of-life care. In one study, for example, scientists funded by NIA found that advance directives can make a difference and that people who document their preferences in this way are more likely to get the care they prefer at the end of life than people who do not.

    Decisions That Could Come Up Near Death

    Sometimes when doctors believe a cure is no longer possible and you are dying, decisions must be made about the use of emergency treatments to keep you alive. Doctors can use several artificial or mechanical ways to try to do this. Decisions that might come up at this time relate to:

  • CPR (cardiopulmonary resuscitation)
  • Ventilator Use
  • Artificial Nutrition (tube feeding) or Artificial Hydration (intravenous fluids)
  • Comfort Care

  • CPR

    CPR (cardiopulmonary resuscitation) might restore your heartbeat if your heart stops or is in a life-threatening abnormal rhythm. The heart of a young, otherwise healthy person might resume beating normally after CPR. An otherwise healthy older person, whose heart is beating erratically or not beating at all, might also be helped by CPR. CPR is less likely to work for an older person who is ill, can’t be successfully treated, and is already close to death. It involves repeatedly pushing on the chest with force, while putting air into the lungs. This force has to be quite strong, and sometimes ribs are broken or a lung collapses. Electric shocks known as defibrillation and medicines might also be used as part of the process.


    Ventilator Use

    Ventilators are machines that help you breathe. A tube connected to the ventilator is put through the throat into the trachea (windpipe) so the machine can force air into the lungs. Putting the tube down the throat is called intubation. Because the tube is uncomfortable, medicines are used to keep you sedated (unconscious) while on a ventilator. If you can’t breathe on your own after a few days, a doctor may perform a tracheotomy or “trach” (rhymes with “make”). During this bedside surgery, the tube is inserted directly into the trachea through a hole in the neck. For long-term help with breathing, a trach is more comfortable, and sedation is not needed. People using such a breathing tube aren’t able to speak without special help because exhaled air goes out of the trach rather than past their vocal cords.


    Artificial Nutrition or Artificial Hydration

    A feeding tube and/or intravenous (IV) liquids are sometimes used to provide nutrition when a person is not able to eat or drink. These measures can be helpful if you are recovering from an illness. However, if you are near death, these could actually make you more uncomfortable. For example, IV liquids, which are given through a plastic tube put into a vein, can increase the burden on failing kidneys. Or if the body is shutting down near death, it is not able to digest food properly, even when provided through a feeding tube. At first, the feeding tube is threaded through the nose down to the stomach. In time, if tube feeding is still needed, the tube is surgically inserted into the stomach.


    Comfort Care

    Comfort care is anything that can be done to soothe you and relieve suffering while staying in line with your wishes. Comfort care includes managing shortness of breath; offering ice chips for dry mouth; limiting medical testing; providing spiritual and emotional counseling; and giving medication for pain, anxiety, nausea, or constipation. Often this is done through hospice, which may be offered in the home, in a hospice facility, in a skilled nursing facility, or in a hospital. With hospice, a team of healthcare providers works together to provide the best possible quality of life in a patient’s final days, weeks, or months. After death, the hospice team continues to offer support to the family. Learn more about providing comfort at the end of life.


    What Is Hospice Care? What Is Palliative Care?

    Hospice care is intended to provide comfort to you and your family during a life-threatening illness, rather than provide treatments to cure the illness. Palliative care is similar to comfort care in hospice, but it is offered along with any medical treatments you might be receiving for a life-threatening illness, such as chemotherapy for cancer or dialysis for kidney failure. The main goal of both hospice and palliative care is to keep you comfortable. In addition, you can always choose to move from hospice to palliative care if you want to pursue treatments to cure your illness.

    Getting Started

    Start by thinking about what kind of treatment you do or do not want in a medical emergency. It might help to talk with your doctor about how your present health conditions might influence your health in the future. For example, what decisions would you or your family face if your high blood pressure leads to a stroke?


    If you don’t have any medical issues now, your family medical history might be a clue to thinking about the future. Talk to your doctor about decisions that might come up if you develop health problems similar to those of other family members.


    In considering treatment decisions, your personal values are key. Is your main desire to have the most days of life, or to have the most life in your days? What if an illness leaves you paralyzed or in a permanent coma and you need to be on a ventilator? Would you want that?


    What makes life meaningful to you? You might want doctors to try CPR if your heart stops or to try using a ventilator for a short time if you’ve had trouble breathing, if that means that, in the future, you could be well enough to spend time with your family. Even if the emergency leaves you simply able to spend your days listening to books on tape or gazing out the window watching the birds and squirrels compete for seeds in the bird feeder, you might be content with that.


    But, there are many other scenarios. Here are a few. What would you decide?

  • If a stroke leaves you paralyzed and then your heart stops, would you want CPR? What if you were also mentally impaired by a stroke—does your decision change?
  • What if you develop dementia, don’t recognize family and friends, and, in time, cannot feed yourself? Would you want a feeding tube used to give you nutrition?
  • What if you are permanently unconscious and then develop pneumonia? Would you want antibiotics and a ventilator used?

  • For some people, staying alive as long as medically possible is the most important thing. An advance directive can help make sure that happens.


    Your decisions about how to handle any of these situations could be different at age 40 than at age 85. Or they could be different if you have an incurable condition as opposed to being generally healthy. An advance directive allows you to provide instructions for these types of situations and then to change the instructions as you get older or if your viewpoint changes.


    Do You or a Family Member Have Alzheimer's Disease?

    Many people are unprepared to deal with the legal and financial consequences of a serious illness such as Alzheimer's disease. Advance planning can help people with Alzheimer's and their families clarify their wishes and make well-informed decisions about health care and financial arrangements.


    Making Your Wishes Known

    There are two elements in an advance directive—a living will and a durable power of attorney for health care. There are also other documents that can supplement your advance directive or stand alone. You can choose which documents to create, depending on how you want decisions to be made. These documents include:

  • Living Will
  • Durable Power of Attorney for Health Care
  • Other documents discussing DNR (do not resuscitate) orders, organ and tissue donation, dialysis, and blood transfusions

  • Living Will

    A living will is a written document that helps you tell doctors how you want to be treated if you are dying or permanently unconscious and cannot make decisions about emergency treatment. In a living will, you can say which of the procedures described above you would want, which ones you wouldn’t want, and under which conditions each of your choices applies..


    Durable Power of Attorney for Health Care

    A durable power of attorney for health care is a legal document naming a healthcare proxy, someone to make medical decisions for you at times when you might not be able to do so. Your proxy, also known as a surrogate or agent, should be familiar with your values and wishes. This means that he or she will be able to decide as you would when treatment decisions need to be made. A proxy can be chosen in addition to or instead of a living will. Having a healthcare proxy helps you plan for situations that cannot be foreseen, like a serious auto accident.


    A durable power of attorney for health care enables you to be more specific about your medical treatment than a living will.


    Some people are reluctant to put specific health decisions in writing. For them, naming a healthcare agent might be a good approach, especially if there is someone they feel comfortable talking with about their values and preferences.


    Other Advance Care Planning Documents

    You might also want to prepare separate documents to express your wishes about a single medical issue or something not already covered in your advance directive. A living will usually covers only the specific life-sustaining treatments discussed earlier. You might want to give your healthcare proxy specific instructions about other issues, such as blood transfusion or kidney dialysis. This is especially important if your doctor suggests that, given your health condition, such treatments might be needed in the future.


    Two medical issues that might arise at the end of life are DNR orders and organ and tissue donation.


    A DNR (do not resuscitate) order tells medical staff in a hospital or nursing facility that you do not want them to try to return your heart to a normal rhythm if it stops or is beating unevenly. Even though a living will might say CPR is not wanted, it is helpful to have a DNR order as part of your medical file if you go to a hospital. Posting a DNR next to your bed might avoid confusion in an emergency situation. Without a DNR order, medical staff will make every effort to restore the normal rhythm of your heart. A non-hospital DNR will alert emergency medical personnel to your wishes regarding CPR and other measures to restore your heartbeat if you are not in the hospital. A similar document that is less familiar is called a DNI (do not intubate) order. A DNI tells medical staff in a hospital or nursing facility that you do not want to be put on a breathing machine.


    Organ and tissue donation allows organs or body parts from a generally healthy person who has died to be transplanted into people who need them. Commonly, the heart, lungs, pancreas, kidneys, corneas, liver, and skin are donated. There is no age limit for organ and tissue donation. You can carry a donation card in your wallet. Some states allow you to add this decision to your driver’s license. Some people also include organ donation in their advance care planning documents. At the time of death, family may be asked about organ donation. If those close to you, especially your proxy, know how you feel about organ donation, they will be ready to respond.


    What About Pacemakers and ICDs?

    Some people have pacemakers to help their hearts beat regularly. If you have one and are near death, it may not necessarily keep you alive. But, you might have an ICD (implantable cardioverter-defibrillator) placed under your skin to shock your heart back into regular beatings if the rhythm becomes irregular. If other life-sustaining measures are not used, the ICD may also be turned off. You need to state in your advance directive what you want done if the doctor suggests it is time to turn it off.

    Selecting Your Healthcare Proxy

    If you decide to choose a proxy, think about people you know who share your views and values about life and medical decisions. Your proxy might be a family member, a friend, your lawyer, or someone with whom you worship. It’s a good idea to also name an alternate proxy. It is especially important to have a detailed living will if you choose not to name a proxy.


    You can decide how much authority your proxy has over your medical care—whether he or she is entitled to make a wide range of decisions or only a few specific ones. Try not to include guidelines that make it impossible for the proxy to fulfill his or her duties. For example, it’s probably not unusual for someone to say in conversation, “I don’t want to go to a nursing home,” but think carefully about whether you want a restriction like that in your advance directive. Sometimes, for financial or medical reasons, that may be the best choice for you.


    Of course, check with those you choose as your healthcare proxy and alternate before you name them officially. Make sure they are comfortable with this responsibility.

    Making It Official

    Once you have talked with your doctor and have an idea of the types of decisions that could come up in the future and whom you would like as a proxy, if you want one at all, the next step is to fill out the legal forms detailing your wishes. A lawyer can help but is not required. If you decide to use a lawyer, don’t depend on him or her to help you understand different medical treatments. That’s why you should start the planning process by talking with your doctor.


    Many states have their own advance directive forms. Your local Area Agency on Aging can help you locate the right forms. You can find your area agency phone number by calling the Eldercare Locator toll-free at 1-800-677-1116 or going online at www.eldercare.gov.


    Some states want your advance directive to be witnessed; some want your signature notarized. A notary is a person licensed by the state to witness signatures. You might find a notary at your bank, post office, or local library, or call your insurance agent. Some notaries charge a fee.


    Some people spend a lot of time in more than one state—for example, visiting children and grandchildren. If that’s your situation also, you might consider preparing an advance directive using forms for each state—and keep a copy in each place, too.


    Future Directions

    A number of states are developing or starting to use an advance care planning form known as POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment). These forms serve in addition to your advance directive. They make it possible for you to provide more detailed guidance about your medical care preferences. Your doctor will talk with you and/or your family for guidance, but the form is filled out by the doctor or, sometimes, a nurse practitioner or physician’s assistant. Once signed by your doctor, this form has the force of any other medical order. These forms are often printed on brightly colored paper so they are easily found in a medical or hospital file. Check with your state department of health to find out if this form is available where you live.

    After You Set Up Your Advance Directive

    There are key people who should be told that you have an advance directive. Give copies to your healthcare proxy and alternate proxy. Give your doctor a copy for your medical records. Tell key family members and friends where you keep a copy. If you have to go to the hospital, give staff there a copy to include in your records. Because you might change your advance directive in the future, it’s a good idea to keep track of who receives a copy.


    Review your advance care planning decisions from time to time—for example, every 10 years, if not more often. You might want to revise your preferences for care if your situation or your health changes. Or, you might want to make adjustments if you receive a serious diagnosis; if you get married, separated, or divorced; if your spouse dies; or if something happens to your proxy or alternate. If your preferences change, you will want to make sure your doctor, proxy, and family know about them.

    Still Not Sure?

    What happens if you have no advance directive or have made no plans and you become unable to speak for yourself? In such cases, the state where you live will assign someone to make medical decisions on your behalf. This will probably be your spouse, your parents if they are available, or your children if they are adults. If you have no family members, the state will choose someone to represent your best interests.


    Always remember, an advance directive is only used if you are in danger of dying and need certain emergency or special measures to keep you alive but are not able to make those decisions on your own. An advance directive allows you to continue to make your wishes about medical treatment known.

    Looking Toward the Future

    Nobody can predict the future. You may never face a medical situation where you are unable to speak for yourself and make your wishes known. But having an advance directive may give you and those close to you some peace of mind..

    Managing Your Medication

    CLICK HERE TO PRINT TABLE

    Information provided by NIH Senior Health at
    http://nihseniorhealth.gov/takingmedicines/managingyourmedicines/01.html

    Taking Medicines
    Take Charge of Your Medicines

    Keeping track of your medicines is very important. Making sure that they are stored properly, that they have not expired when you take them, and that prescriptions are refilled requires time and attention.

    Also, taking many different medications at the same time is difficult. It can be hard to remember what each drug is for, when you should take it, and how you should take it. This is especially true for people with memory problems. However, there are simple strategies you can use to help you manage your medicines wisely.

    Simple Strategies
  • Keep a checklist of all the prescription and over-the-counter medications you take. For each medicine, mark the amount you take, the time of day you take it, and whether it should be taken with food. Store two copies of the list: one on the refrigerator door or where your medications are stored, and one in your wallet or purse. You may wish to print out the enlarged version of the chart on this page to help you.
  • Review your medicine record at every visit to the doctor and whenever your doctor prescribes new medicine. Your doctor may have new information about your medicines that might be important to you. Whenever possible, have your health care provider write down advice and instructions for taking each medication. Keep this information handy.
  • Woman selecting pills from pill dispenser. - Click to enlarge in new window. Click for more information
  • Ask your pharmacist to provide your medicine in large, easy-to open containers with large-print labels. Keep medicines in their original containers, and never put more than one kind of medicine in the same container. Consider using multi-day dispensers that organize your medicines by the day and time that you should take them.
  • To determine how a medication should be stored, ask your doctor or pharmacist and/or read the label. Some medications must be stored in the refrigerator. Your bathroom medicine cabinet is not a good place to store most medications due to the moist, warm conditions that can cause drugs to break down more quickly.
  • Don't stop taking a prescription drug unless your doctor says it's okay -- even if you are feeling better.
  • Get prescriptions refilled early enough so you won't run out of medicines. Running out could cause problems with your medicine schedule. Check expiration dates frequently and discard any medicines that are out-of-date.
  • Keep all medicines out of the sight and reach of children and away from pets. If children do visit your house, be extra cautious and have the phone number of the nearest poison control center handy.
  • Before you travel, ask your doctor or pharmacist how to adjust your medicine schedule to account for changes in time, routine, and diet. Bring the phone numbers of your doctors and pharmacists with you. When flying, carry your medicines with you; do not pack them in your checked luggage. When traveling, always keep medicines out of heat and direct sunlight.
  • Set timers and reminders to take your medicines, if needed. Program clocks for when you are at home, and cell phones and watches when you are traveling.
  • Your Pharmacist Is a Resource

    Finally, the pharmacist is a good source of information about your medicines. In addition to answering questions and helping you select non-prescription medications, your pharmacist keeps records of all the prescriptions you get filled at that store.


    Because the pharmacist keeps these records, it is a very good idea to have the same store fill your prescriptions whenever possible.

    In Case of Accidental Poisoning

    Be prepared in case of accidental poisoning involving medications or other substances. Call Poison Help at 1-800-222-1222 to speak with a poison expert at the poison center serving your area. The service is free and available 24 hours a day, 7 days a week, and calls are always free and confidential. Interpreter services are also available in 160 languages. Keep the number programmed in your home phone and mobile device.