Palisades Alliance

Report on December 2 managing caregiving program

Many attended Pam Nye's December 2 presentation on caregiving. Following is our trusty notetaker's report on the program:

Seniors mostly want to remain at home. They cherish their independence. However, many will eventually need help with  minor or essential tasks and need a caregiver. Some will need help with household chores, others with cooking,  shopping, paying bills. Some will need more intimate help.

As we age, we may lose the ability to think clearly; changes in our frontal lobe may decrease our perception of what is acceptable behavior... Maybe we forget to  turn off the stove; lock the door, even take our medications as ordered, feed ourselves properly. There may be problems of continence as the pelvic floor weakens and protection needs to be used. It is embarrassing and, if this is noticed by a f riend or family member, needs to be addresses tactfully..

 

Some problems may be sudden (illness, a fall, even a stroke); some develop slowly.

The Barthel Index evaluates 10 activities of daily living, for instance: toilet use, mobility, dressing...

 

When it it time to get help?

 

This decision needs to be done tactfully and with grace. Many older people will resist, often till an accident occurs.

The realization of the inevitability of  help is depressing. Grief settles in, also sometimes guilt and shame. Sometimes people retreat in their homes, do not want   friends to see t hem in this situation...

 

Who will help?

 

One needs someone with a kind heart, strong back and clear mind.

 

Often the task falls to the closest and willing family member.  

Care giving can become a full time, onerous, job with very little time for oneself, physically challenging. In couples, this may bring resentment, loss of intimacy, even divorce. The caregiver needs to take care of  herself/himself so that she/he can take care of others...

(There is a caregivers support group at St John Hospital; there will be others there to talk to; these meetings will bring much needed camaraderie). AARP has a help line.

 

Caregiving changes both the caregiver and the one receiving care, in part because of the intimacy of care given...

 

One can also hire health care practitioners such as licensed practical  nurses (LPNs) or nurse's aides.

 

 

How to pay for it?

 

additional costs can be enormous.

When finances are limited, older people can use a reverse mortgage on the home that may have appreciated along the years; use a life insurance policy as collateral for a bank loan,  borrow money from the policy (viatical loan), or sell the policy.

 

maybe one has investments.

 

- one can also contact  family member for offers of help...

 

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questions from the audience

 

Q - I am getting old and my doctor does not answer my questions to my satisfaction.

A - Your doctor has a limited amount of time; try and see a gerontologist; he/she  may also help you find a social worker to assist you.

 

Q-  I have been a caregiver several times. I think safety is the  most important consideration, but eating can be a big problem..

A-  Contact Meals on Wheels. If swallowing is a problem, consider the help of a speech therapist.

 

Q- How to have food brought to the home?

A- Supermarkets (Vons,  Ralphs, Gelson's, etc.) do deliver, as does Instacart.

    If  you are a Kaiser Permanente member, they have a service that helps supply cooked meals to your home; they consider the various diets, according to one's special condition.

"When Help Is Needed: Managing Caregiving" - December 2 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' December 2 program, titled "When Help Is Needed: Managing Caregiving.” 

Our speaker will be Pamela Nye, Assistant Professor at the UCLA School of Nursing.

When our loved ones encounter medical difficulties, we enter unfamiliar territory. How will you know when it’s time to provide caregiving? What if the loved one disagrees with your assessment? Who will the caregiver be? How can you prepare?

Today’s program is the first in a projected series that will continue periodically in 2020, and is intended to support family caregivers. Subsequent programs will address such topics as anger and belligerence, physical care, memory loss and forgetfulness, and how to manage the loved one’s difficult behaviors both in public and in private. The sessions will be stand-alone, with no requirement to attend all; however, those who attend regularly are more likely to find connection with others in similar circumstances.

Pamela Nye works with patients who suffer neurological and neurosurgical conditions and surgeries.  She is a widely sought after speaker locally, regionally and nationally.  She recently retired from a position as Neuroscience Clinical Nurse Specialist at UCLA and Stroke Coordinator at Santa Monica Hospital, and restarted her private consulting business where she works with local hospitals, colleges, clinics, and community centers.

Ms. Nye previously spoke to Palisades Alliance for Seniors in 2017 on the topic of “What Makes People Happy,” and in 2016 on the topic, "When Stroke Presents as Cognitive Decline."

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. 

Report on November 18 retina and vitreous program

Dr. Daniel Su spoke to an attentive group concerned about retina and vitreous issues.

Following is our trusted notetaker's report:

Dr Su, a retina specialist, started his presentation by giving us a brief description of the eye anatomy.

He then proceeded to discuss at some lengths several of the more common eye problems affecting the older population.

 

Cataracts -

 

  As we age, the lenses of our eyes get more cloudy and less able to focus on  nearby objects. Diabetes, traumas, exposure to radiation or excessive sun light can hasten formation of these cataracts.

 

 The patients need to be observed as, although vision acuity may be diminished, patients' needs are different and some may not be inconvenienced as fast as others.

 

 At surgery, a clear lens will be inserted to replace the damaged one. This is a very common surgery with low risk (95% success rate is the norm), and it is done on more than 3,000,000 patients a year in the US.  The patient will be under local anesthesia and the procedure done on an outpatient basis. There will be a return visit the next day; recovery is normally quite fast. A decision will be  made prior to the surgery as to the degree of correction desired. corrective glasses may be needed after the procedure.

 

  Newer intraocular lenses with multiple focusing powers may allow the patient to have good near and distant vision, but normally the results of that procedure are not perfect.

 

  In countries where this surgery is not available, cataracts are the  main source of blindness.

 

Macular degeneration - It is the most common cause of vision loss.   The main risk factors are: age, being a Caucasian, smoking and family history.

 There are two kinds: dry and wet:

 

 Dry macular degeneration is quite common; it progresses slowly; it may lead to a scarring of the macula and loss of central vision.

 Unfortunately there is no effective treatment so far. Cessation of smoking is a good idea, as is eating lots of vegetables and taking special vitamins such as AREDS2; these are available over the counter in pharmacies.

 

Wet macular degeneration affects about 15% of the  population. Abnormal blood vessels develop under the  macula; small cracks form in the retina and cause bleeding. The treatment consists of an injection, given at regular intervals, right in the eye.  The procedure is done in the doctor's office.

 

In  Wet macular degeneration, the central vision, if untreated, worsens. Vision at the outer edges of the eye is generally not affected.  Several research approaches to this condition are under way,  among them stem cell therapy, microchips implants, and newer injectable drugs are in the works, that would require fewer visits to the doctor.

 

Retinal Detachment -

  This condition manifests itself by a 'shower' of points or multiple flashes of light, and a loss of peripheral vision. It may affect the central vision.

  Treatment usually involves laser surgery to repair the tear and seal the retina to the back of the eye. It may involve injecting gas into the eye to flatten the retina, applying gentle pressure to the side of the eye to repair the detachment, or removing all of the gel that fills the eye (vitrectomy).

  It is IMPORTANT to treat this condition as quickly as possible to avoid permanent damage to the eye.

 

Questions from the audience followed:

 

Q: What is Lasik treatment?

A: It is also called laser eye surgery. It will correct the shape of the cornea and consequently improve vision. Not everyone is a candidate. The results are 

immediate and dramatic!  

 

Q: When to see an ophthalmologist?

A: As soon as there is a serious concern. In case of suspected retinal detachment, it is strongly suggested not to go to a hospital emergency room as there will be a wait and the surgery needs to be done fast. Locally, one's best bet is either Santa Monica Hospital on 18th street or the Jules Stein Clinic at UCLA Westwood; the latter has a walk in clinic.

 

Q: how about seeing an optometrist, since we have no ophthalmologist in the neighborhood?

A: This would be a first step as the optometrist has special training; he/she could then refer you to a local specialist.

 

Q:  How about dry eyes?

A:  This is common condition as we age; special eye drops several times a day will help with the problem.

 

Q: What is Preservision? 

 A: Another name for the special vitamins AREDs2 sold over the counter in pharmacies.

 

Q: Is increased eye pressure a sign of glaucoma?

A: It may be. See your eye doctor. The condition can be treated.

 

Q: In wet macular degeneration, does the long term use of injections in the eyes weaken the eyes?

A: No. The main concern of  these injections if infection. there is a 1 to 2% chance of infection. Betadine is the only 'cleaning' medication used so far, as authorized by the FDA for this.

 

Q: If  the retina is detached, does it regenerate?

A: Alas, no.

 

Q: Can a pharmacist help with allergies?

A: There are over the counter medications; however, your ophthalmologist is the best person to consult.

 

Q: What does the needle do in the treatment of wet macular degeneration?

A: It inserts the medication.

 

Q: Where to go for retinal problems treatment?

A: There are  many ophthalmologists in the area with this specialty; also, of course St. John's Jospital and the Jules Stein clinic at UCLA.

 

Q: What are the  main  problems with the Lasik surgery?

A: choosing the right lens size.

 

Q: does Lasik surgery increase eye pressure?

A: Not that the doctor knows about...

 

Q: Does diabetes cause eye problems?

A: alas, yes;  Diabetes needs to be treated urgently and thoroughly..

 

Q: Is the Doheny Eye Clinic still in Pasadena?

A: Yes!

 

Q: What is double vision?

A: it is caused by poor focusing, sometimes due to cataracts or dry eyes.

 

Q: Is there is support group for patients suffering from macular degeneration?

A; Not that Dr. Su knows of at this time...

"Retina & Vitreous Disorders" - November 18 - 10:30 a.m. @ Library

 

Please come to Palisades Alliance for Seniors' November 18 program, titled "Retina and Vitreous Disorders.” 

Our speaker will be Daniel Su, M.D. Dr. Su is a physician with Retina-Vitreous Associates Medical Group in Los Angeles.

The retina is a thin layer of tissue on the inside back wall of your eye that’s responsible for vision. Dr. Su will review a few diseases that can affect the retina, including macular degeneration, macular holes, retinal tears and detachment. He will discuss warning signs for retinal disease, and what vision changes indicate the need for immediate medical attention.

Dr. Su received his undergraduate degree from UCLA and his medical degree from the Icahn School of Medicine at Mount Sinai in New York. Following an internship at Cedars-Sinai Medical Center in Los Angeles, he completed his residency training in ophthalmology at the Jules Stein Eye Institute at UCLA. He went on to complete a two-year vitreoretinal surgical fellowship at the renowned Wills Eye Hospital in Philadelphia.

He has authored numerous peer-reviewed scientific publications and textbook chapters on vitreoretinal diseases and has been an invited speaker to present scientific papers and abstracts at various national ophthalmic and retina subspecialty meetings. He has been recognized with awards for both research and surgery.

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Report on November 4 "processing our fire experience" program

 

This program was added at the last minute in response to the Palisades and Getty fires that threatened residents over the past two weeks.   The program originally planned for November 4, on Social Security, will be rescheduled.

We are grateful to Palisadian Marvin Kaphan, a psychotherapist with deep experience in working with groups, for guiding the impromptu session.   Mr. Kaphan, an LCSW and MFT, is a Diplomate of the American Board of Examiners in Clinical Social Work and a Certified Group Psychotherapist. He has engaged in the full-time private practice of psychotherapy since 1960. For almost all that time he has been an enthusiastic advocate of group psychotherapy, and has maintained six ongoing groups in addition to a full schedule of individual sessions.

Mr. Kaphan has studied at CCNY, NYU, Princeton University, Rutgers University, and Columbia University. He has taught at several local colleges and has served as a field teacher for the University of Southern California School of Social Work.  His experience has included residential treatment, child guidance, play therapy, and supervision in various settings. Mr. Kaphan was the first full- time professional employee of the Los Angeles Suicide prevention Center at its inception. He was chief Psychiatric Social Worker when he left.

Mr. Kaphan has done many demonstrations and lectures in Los Angeles and in other parts of the United States and Canada. On two occasions he has addressed the American Psychiatric Association. In 2006, he was awarded the prestigious VIDA (Vision, Innovation, Dedication, Achievement) award by the Group Psychotherapy Association of Southern California. In 2010, he was named a Life Fellow of the American Group Psychotherapy Association. He was President of the Group Psychotherapy Association of Southern California for two successive terms.

Our erstwhile notetaker attended the program and filed this report:

Fifty-two of us gathered in a circle, and under the gentle and encouraging hand of our facilitator Marvin Kaphan, recounted their recent experiences of the two fires.

 

We were told of the advantage of talking about these experiences for a while as people easily forget.

 

Mr. Kaphan started by asking how people felt when they first heard about the fires:

 

- A lifelong diabetic gathered all her supplies close by and recounted her special vulnerabilities. She keeps a supply in her car, just in case.

 

-Iris heard about the fire a couple of hours late; living South of Sunset, she did not really have to evacuate, but needed to be alert to the possibility at any time.

 

- On Bollinger Drive, outside the compulsory evacuation zone, a lady was awakened by phone and found out the exact fire info by googling Pac Pal fires. She had to help a 92 year old neighbor with bad hearing, if needed.

 

- Somebody said she had been terrified, awakened by her dog, as she had removed her hearing aid before going to sleep.

 

- A lady  who does not drive explained how vulnerable she felt. A neighbor offered her a couch, but she is a poor sleeper. The whole experience terrified her.

 

Many people enumerated their transportation problems and traffic concerns:

 

Quite a few seniors do not drive any more and depend on others. Some decided to  just 'shelter in place', but this is not always the wise solution and can lead to dire consequences.

 

- Sue, on Galloway, saw a policeman on the street who advised her of the  necessity to evacuate; she packed her medication and decided to walk to the Red Cross shelter near the library; 10 to 15 people were already there; it was very nice. She got a ride back home, at first felt ok and then a bit shook up...

 

- A couple, in the  mandatory evacuation zone, did not have a car but were picked up by a police car and taken to the Red Cross center; the elderly husband got confused and started talking about  his brother who died in 1944.  Interestingly enough, the shelter was pretty close to the fire zone... and some people wondered why it had been allowed to operate there..

 

- Esther, who mentioned that she likes to  make plans, decided that the Red Cross center was too close to the fire zone and decided to just stay home as her building was not in the compulsory evacuation zone. She mentioned how exhausting the decision making process was.

 

- A lady, who has two cats - one of them that cannot be easily captured - was wondering where to go with the two cats. decided it was better to just leave them at home with food and water - a frightening state of affairs. Being alone was difficult. Fortunately, a  neighbor in the building was helpful and they talked a few times. She stated that it felt like a very scary situation.  Being on alert is very stressful.

 

- One person took Sunset to PCH. Driving towards Santa Monica, she recounted, was a 'parking lot situation'. Going towards Malibu, however, was apparently easy.

 

- A TV program depicted a couple picking up a  young couple in their car and the car burnt out.

 

- Garage doors - A reminder that one  needs to have a system where there is a battery back up for the door, if the garage door opens electrically and the manual system is too hard to operate.

 

Miscellaneous points raised:

 

- Smoke problems: If one decides to  shelter in place and the fire from the smoke gets close, it is  NOT a good situation...

 

- Fire in the canyon - Palisades Drive:  At the time of the first fire, the bottom of the canyon was closed, the fire road also; sheltering in place was the order received. A very worrisome situation  where one fears to end up killed by the fire!

 

- A gentleman complained that the situation was being politicized, as President Trump was criticizing the way our governor was mishandling our state's fire dangers.

 

- A recent article in the Los Angeles Times explained that, fortunately, there was a great source of water at the top of our local Santa Monica mountains, in the form of several private water reservoirs that the owner of the site left at the disposal of the fire department; helicopters can 'suck' water out of the reservoirs and dump it immediately in the vicinity.

 

- Iris recounted an episode where her sister called from Mexico City and said 'I do not want to tell   you what to do, but.... go to Santa Monica."

 

- Esther mentioned that the thought of  having to deal with electricity was very worrisome: no TV, phone, use of elevators, etc.  For her, the most important thing was to feel she could function.  She also found it very reassuring to have someone with them.  She suggested that one could ask a neighbor to come and stay with one and vice versa.

 

Attendees asked, Where are we as a collective?  Where is the block captain? 

Some thoughts to  ponder... Organizing some kind of network with  neighbors would be a good idea.

 

Mr. Kaphan asked us  to think about what we would do differently next time:

 

- Someone mentioned getting all info on her neighbors on her street, phone numbers, emails - a high tech solution - LOTS to think about.  In general, it's important to get to know one's neighbors.

 

- Everyone was so grateful to our wonderful Fire Department! A suggestion was made to give a contribution to them..

 

- At the last meeting, we were given some plastic signs to  hang on our door knobs indicating whether we  needed help or  not; it is a good idea to have these signs handy.

 

Mr. Kaphan encouraged us  to deal  with our ongoing feeling of fear by sharing our feelings:

 

Our lasting anxiety produces adrenaline and hormonal changes; we have to take steps to protect ourselves by connecting  more with  neighbors and friends and talking with others.

 

Palisades Alliance will be having another meeting in the future to help us better prepare, learn how to deal with stress and reach out to each other. Seventy per cent of people saved in fires are saved by their neighbors, apparently...

 

Councilman Bonin has scheduled a Fire Safety meeting at Paul Revere Middle School for Saturday, November 9.  Information here.

Program Change for November 4 Meeting at Library! We'll still meet, but the topic has changed.

 

Please come to Palisades Alliance for Seniors' November 4 program.  The topic will NOT be Social Security.

Instead, in light of the recent fires, this meeting will be a session where attendees can, if they wish, share their feelings and experiences. The program will be led by Marvin Kaphan, a psychotherapist experienced in facilitating groups.

The Social Security speaker will be rescheduled for a later date.

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. 

Report on October 21 resilient neighborhoods program

This was a most timely program.

Following is our intrepid note-taker's report:

The substantial audience attending K.C. Soll and Stephanie Benjamin's presentation were reminded of useful steps to take for preparing - and living - with an emergency such as fire, earthquake.  

 

- First, in preparation, reach out to family members - or friends - out of town and give them all contact information; a reminder: texting often still works when emailing and phones do not!

- Update one's contact information.

- Have a complete list of needed medications, health issues (such as  mobility problems, etc); getting an emergency 'bracelet' with contacts' numbers and medical info, is a good idea.

 

Remember that there is no emergency room in our neighborhood, although quite a few resident physicians.

 

Wildfires issues -  these become more of a norm; keep up with all announcements! (sadly we were in the middle of one in the Highlands' neighborhood at the middle of the  meeting).

 

Sheltering in place -  is not generally considered a good idea by the Fire Department (although it may be necessary in the Highlands, a special case); have an alternate safe location in mind.  If you do intend to shelter in place, equip yourself with food and water for two weeks at least.

 

if you don't drive - arrange to have someone come and pick you up - a backup plan.

 

Designate two people out of town to contact friends.

 

Emergency Medical Kit - have two weeks of  medications there; one blood pressure kit; a copy of your medical record (main issues); written information

      about ongoing treatments; copies of your medical insurance cards.

 

Also keep a first aid kit in your car, as well as a fire extinguisher.

 

Water - one gallon a day is the recommendation and a three days  minimum supply.

 

In a major disaster:

• Turn the water off.  The purpose of this is to prevent structural damage to the home because of possible broken water pipes.
• Have a minimum of three days food that will not spoil; a flashlight, a manual can opener, a whistle, a charger for your cellphone; maps (Thomas guide) as it  may be complicated to get out of one's area due to road conditions; some clothing and a blanket; also some cash  in smaller bills ($200 recommended).

Evacuation? 

• The evacuation routes may be limited; the roads may be dangerous; landslides may occur, especially along PCH (Malibu fault).
• Stay away from power lines; do not touch them. It is better to avoid PCH.
• Palisades Drive is an ancient river bed; it can also get blocked. The gas and electric companies are aware of the special conditions in the  Highlands; sheltering in place will be needed there. There may be issues of fire and water at the same time.

At Home ?

• Anchor furniture; no mirror over the beds;
• If indoor when an earthquake strikes, stay indoors - Drop, Cover, and Hold!
• Be prepared for likely aftershocks.

Q and A:

 

Q: If you are evacuated, how about traffic lights?

A: If they are just blinking, this means stop.

 

Q: How to make sure the water is safe?

A:  Buy some purification tablets at stores such as REI; or, if you are able to, boil the water.(plastic water bottles have a limited shelf life)

A:  A55 Gallon water container can be acquired; it is a type of barrel with wrench and pump. when empty, rinse and cleanse with chemical meant for this purpose, and refill.

 

The CERT Program

 

Anyone can sign up and take the classes; it you want to join they will use you in a varied capacity. You will be taught how to earhthquake proof your home; use fire extinguishers, render basic first aid, some wound care;  help lift people; do some search and rescue; learn how to lift up heavy objects and how to generally deal - physically and  emotionally - with disasters. 

 

Q: how long does training last?

A: 18 to 21 hours.

 

Some classes are given on Tuesday nights; others on Saturdays and Sundays. Santa Monica has some classes, priority given to residents, but will accept out of town people.

 

In Conclusion:

 

Be prepared! 72% of people apparently think they will get emergency care. UNTRUE. We need to be ready and help each other!

 

NOTE: We were given cardboard door hangers;  one side said OK Evacuated; the other side HELP. Both sides had spaces for phone numbers and emails.  On the HELP side there was also a space for the number of adults and kids, pets, medication, and emergency contact phone number.

 

Also given was an Evacuation checklist and an American Red Cross PrepareSOCal: 21 Weeks to Prepare!

"RESILIENT NEIGHBORHOODS: how coming together before a disaster ensures care for all" - Monday, Oct. 21 - 10:30 a.m. @ Palisades Library

 

Please come to Palisades Alliance for Seniors' October 21 program, titled "Resilient Neighborhoods: How coming together before a disaster ensures care for all.”  Our speakers will be K.C. Soll, who helms the Palisades Community Emergency Response Team (CERT), and Stephanie Benjamin, who is a public safety expert.

The speakers will discuss what you can do to prepare for emergencies, what supplies you should have on hand in your home, and how you can get involved in the CERT program.  

In case of a disaster or emergency, it is important to know how to protect yourself, your family, your neighbors, and your neighborhood. The LA Fire Department set up the CERT program to ensure that the population has the best possible chance of surviving a disaster and thriving afterward.

A key tenet of the CERT program is giving people the knowledge to be able to help themselves and their neighbors in the event of an emergency until public safety personnel are available. (If there is a significant earthquake, phones and other communications channels may be interrupted, and Fire Department personnel and first responders may be delayed for days or weeks on end.)  Under the guidance of local government, CERT members will be able to organize and assist in the emergency. Jobs can vary; in a disaster there will be a need to fill positions in everything from filling out paperwork, to child care, to search and rescue. If you are willing to volunteer, CERT will do its best to find a place for you.

K.C. Soll is part of a team of four people, all CERT and ARES (Amateur Radio Emergency Services) ham radio volunteers, who have been organizing preparedness lectures and training in the Palisades for years.

Stephanie Benjamin has worked in emergency management, response, education and preparedness for more than twenty years, utilizing her skills to respond to disasters and educate communities. She operates an emergency preparedness business and has an M.S. in emergency management. She has taught CERT for 15 years and been an EMT for 21 years.  

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Report on October 7 healthy sleep program

 

There was a large audience for Dr. Cathy Alessi's presentation.  Our regular notetaker is deferring to Sue Pascoe, editor of the Circling the News blog, who published this report.

"Healthy Sleep" - October 7 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' October 7 program, titled "Healthy Sleep.”  Our speaker will be Cathy Alessi, MD, a Professor of Medicine at the David Geffen School of Medicine at UCLA, where she is Associate Director of the Multicampus Program in Geriatric Medicine and Gerontology.  

Dr. Alessi will discuss the purposes and processes of sleep, and suggest approaches toward attaining better sleep.

Dr. Alessi is a Past Chair of the Health Sciences Section of the Gerontological Society of America, and a Past President and a Past Chair of the Board of Directors of the American Geriatrics Society, and is currently the Chair of the Research Committee of the Sleep Research Society.  Her research focuses on descriptive and interventional research to improve sleep problems in older adults.  

A native of Illinois, Dr. Alessi obtained her undergraduate degree at the University of Illinois in Urbana/Champaign, and her medical degree at the University of Illinois College of Medicine in Chicago. She completed Internal Medicine residency at Michael Reese Hospital Medical Center in Chicago, and Geriatric Medicine clinical and research fellowships at the University of Chicago. 

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Report on September 23 foot and ankle program

 

This was an extremely informative presentation about foot and ankle issues.  Dr. Hassid kindly agreed to let us post his slide show as well as the handout.   

Click following link to Download Dr. Hassid's slide show on common foot and ankle problems. 

Click link to Download Dr. Hassid's handout on fall prevention.

 

"Foot and Ankle Ailments" - Sept. 23 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' September 23 program, titled "Foot and Ankle Ailments.”  Our speaker will be Arash Hassid, D.P.M., FACFAS, director of the SoCal Foot and Ankle Center.

As we age, the likelihood increases that we will encounter foot issues such as nail disorders, corns and calluses, hammertoes, bunions, plantar fasciitis, hallux valgus, neuropathy, edema, and heel and arch pain. Foot problems and pain can inhibit daily activities, leading to a decrease in mobility that can exacerbate other age-related conditions. Dr. Hassid will answer your questions about these problems and discuss approaches and interventions that can alleviate pain and improve function.

Dr. Hassid is a podiatric foot and ankle surgeon who has been in practice for fourteen years. He is a member of the American College of Foot & Ankle Surgeons, and is board certified in foot surgery with the American Board of Foot & Ankle Surgery.  He has practices in Cedars Sinai Medical Towers and Santa Monica Medical Plaza.

Dr. Hassid completed a three-year comprehensive foot and ankle surgical residency at the Veterans Administration Program in West LA and at UCLA's Olive View Medical Center. He received his D.P.M. degree from the California School of Podiatric Medicine, Samuel Merritt College, and his B.S. degree in Psychobiology from UCLA.  

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon. 

Report on September 9 genealogy program

LAPL Genealogy librarian Julie Huffman delivered an extremely informative presentation on how to approach researching one's roots, and the impressive set of resources available from the Los Angeles Public Library. 

The meeting was followed by a lovely luncheon on the library patio, underwritten by a generous grant from the Palisades Woman's Club, and coordinated by wonderful volunteers Therese Funk, Donna Sheridan, Jackie Dubin, Ginnie Navon, Ron Segall, and Anne Kupfer.. 

Ms. Huffman is letting us post her Powerpoint presentation here.  Click link to Download Julie Huffman LAPL genealogy presentation 9-9-2019 .

Following is our loyal scribe's report on the program from the audience perspective:

Our presenter was wonderful, detailed and cheerful.  

 

There is very little I can add to the detailed power points, as they are very precise...

 

Just a few comments:

 

- when researching ancestors, if  you have a chance to talk to your relatives, do so, and make sure to record what they are saying; these are precious memories. Start with  yourself and work your way back up.

 

- When looking at the records listed in the census, NA stands for naturalized.

 

- The Mexican churches have put all their records on line.

 

- Librarians in the History/Genealogy department will assist you with your research but, of course, will not be able to do it for you.

 

- You can locate several 'how to' books at the lapl.org site and have them sent to your branch library, as long as they are not reference  material.  

 

- Being a little familiar with the downtown library, I was always amazed at the huge amount of various indexes available for research, including the newspaper files and in particular the California file -  continually updated on people and places.

 

- City directories - the last one was published in 1942; they are amazingly 'personal' in that they list not just names but also infomation such as widowhood... type of jobs and even, occasionally, location of the jobs.

 

- A list of genealogy researchers is available at the downtown library, about 15 of them in the L.A. area; call for rates. Also a list of people doing adoption research and private investigation.

 

- To reach the LAPL, call 213-228-7000.

 

- The fire insurance Sanborn maps are a wonderful/detailed source of info, as each house on each block is listed and you can find details of the homes: a precious resource in case of proposed remodels.

"Genealogy: How to Find Your Family Roots (with some help from the Los Angeles Public Library)” - September 9 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' September 9 program, titled "Genealogy: How to Find Your Family Roots (with some help from the Los Angeles Public Library).”  Our speaker will be Julie Huffman, Genealogy Librarian at the Central Library.

Ms. Huffman will discuss the basics of researching your family’s history. Learn how to get started searching census records, military records, newspapers and more. Participants will also discover the many genealogy resources available at the Los Angeles Public Library.

Julie Huffman has been the genealogy librarian at the Central Library downtown for five years, and—over the course of 18 years at LAPL—a young adult, children’s, and adult reference librarian.  Her MLIS is from UCLA and she has a Bachelor’s of Journalism from the University of Missouri-Columbia. Julie's heritage is Swedish, English, Scottish, German, Swiss, and Canadian, but she is always striving to learn about all genealogical interests!

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon. Attendees are invited to stay and socialize after the program over a light lunch on the library patio, offered courtesy of a grant from the Palisades Woman’s Club.

The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. 

Report on August 12 getting comfortable with Android phone class

Our speaker, Kainoa Kanter, provided a high-level tour of Android devices' capabilities, and assisted audience members in setting up their apps for more effective usage.  Our scribe was too busy following along to take further notes!

"Getting Comfortable With Your Android Smartphone or Tablet" - August 12 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' August 12 program, titled "Getting Comfortable With Your Android Smartphone or Tablet."

The speaker  will be Kainoa Kanter, a rising junior at Palisades Charter High School. Seniors who previously participated in the technology tutoring sessions that Palisades Alliance for Seniors ran in conjunction with the high school will remember Kainoa as the expert to whom other students turned  when even they were stumped by a problem.

As technology is evolving with society, it can be hard to keep up. The objective of the program is to help seniors learn how to better use their technology, from the basics to proficiency.  At the beginning, using a smartphone can seem daunting, but it does not take long to become intuitive.  The idea is to get you over that hump.

Attendees are encouraged to bring to the meetings the device(s) that they want to learn how to use.  

The program will take place in the Palisades Branch Library's Community Room, and run from 10:30 am to 12:00 noon.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. The programs are open to all, and free of charge.

Report on August 5 getting comfortable with Apple devices program

 

Our program speaker,  Karen Stigler, opened the presentation by emphasizing three cardinal rules for attendees to remember:

1. You cannot break the phone except by dropping or drowning it.
2. Mistakes can be undone; and
3. You can solve almost every problem through Google or else Apple Support.

She noted that the phone is a hand-held computer that can do everything, kind of a Swiss Army Knife. It’s a phone and a camera. It’s also a flashlight, a web browser with keyboard, an alarm clock, a timer, a magnifying glass, a GPS, a phone book, a calendar, and a way to video chat with friends or family.

After a tour of key features, concepts and vocabulary, the speaker covered settings, phone calls and voicemail, camera and photos, and navigating the home screen and apps.

She encouraged attendees who run into problems to look for the answers online, either by googling the question, or by making an appointment (via Apple Support app -- download in App Store) with Apple to get support either by phone or in person at the Apple Store. 

For those who want to learn more, there are many free online video tutorials available (google "free online iPhone class).  Another good option is Apple's free classes in Santa Monica (register online  through the Apple Store app).

"Getting Comfortable With Your Smartphone or Tablet" - August 5: Apple Devices; August 12: Android Devices - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' August programs, titled "Getting Comfortable With Your Smartphone or Tablet." The August 5 program will focus on Apple devices, i.e. using the iOS operating system.  The August 12 will focus on devices using the Android operating system.

As technology is evolving with society, it can be hard to keep up. The objective of the program is to help seniors learn how to better use their technology, from the basics to proficiency.   At the beginning, using a smartphone can seem daunting, but it does not take long to become intuitive.  The idea is to get you over that hump.

Attendees are encouraged to bring to the meetings the device(s) that they want to learn how to use better.  

The programs will take place in the Palisades Branch Library's Community Room, and run from 10:30 am to 12:00 noon.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. The programs are open to all, and free of charge.

Report on July 22 Stop Senior Scams dramatic presentation

A full house of Palisadians turned out to enjoy this entertaining and educational program.  We are grateful to the Stop Senior Scams Acting Program, who put up with a frustrating bus ride to join us. 

Following is our loyal scribe's report.  Scroll down for photographs.

A very lively troupe presented to our audience the following senior scams:  

• Seniors looking for love... Lonely seniors (possibly recently widowed) end up losing their homes, money. The scammers gain the victims' trust, by also accessing obituaries-

Advice: never give anyone your social security card, bank account or credit card  numbers!

Report any suspected fraud to the FTC.

• DNA testing ...Innocent seniors are invited to a  seminar; are asked for their social security card numbers; these cards are then used fraudulently.

Advice:DNA testing is  NOT covered by social security!

• Electronic pick-pocketing ...Credit cards information is scanned by a wand with a scanner.

Advice: Credit card companies have developed protections for your cards; obtain these.

Seniors are too embarrassed often to report being victims of these scams. (Some of these are  done by family members and/or 'friends)

Especially affects seniors living alone and/or suffering from dementia.  Fraudulent calls happen also in assisted living facilities.

• Social security cards fraudulent calls ....The caller pretends to be a social security official and will try to obtain one's card number.

Advice:  Just hang up!

(Real social security personnel never calls) 

(Now the s/s numbers have been removed from Medicasre cards; put away your old card in a safe place and/or destroy it)

The social security fraudulent calls somehow replaced the IRS fraudulent ones!

• Driving scams...Someone will pretend that  you hit them and ask for cash rather than  going to go thru the trouble of calling insurance as  the insurance would go up..)

Advice: Call the police! and take photos of both cars with your cell phone.

• Grandkids calls...Caller pretends to be grandkid in trouble, or to be holding grandkid for kidnap.  Asks you to send money and not tell the kid's parents.

Advice: Set up 'code words' with your grand kids in advance. ask the caller to give  you this code word.

(One scammer confessed to being able to 'in a good day' make $10,000 this way.

Scammers can call from jail even...

• Finally, the main advice was JUST HANG UP!!!!!!!

Phone numbers you can call to report scams:

 

FBI: 310-477-6565

 

FTC: 310-824-4300

 

Our wonderful group of actors goes to more than 30 locations a year to educate seniors.   Councilman Mike Bonin is a big supporter of this program that was started by Councilman Bill Rosendahl.

 

  

"Stop Senior Scams" - July 22 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' July 22 program, featuring a performance by the Stop Senior Scams ℠ Acting Program of Los Angeles.  Come learn to protect yourself and your loved ones from scams that target older adults.   

Stop Senior Scams ℠ Acting Program uses theater to dramatize senior scams and educate older adults about the dangers of fraud and how to prevent it.  The performers, aged 60 to 97 years old, use skits to demonstrate their experiences to teach you how to identify and stop elder abuse. 

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. 

Report on July 8 estate planning basics program

 

There was a full house for this useful program, presented by attorney Dani Kaiserman of the Bet Tzedek public interest law firm.  Many stayed afterward for a lovely lunch on the library patio, offered courtesy of a generous grant from the Pacific Palisades Woman's Club. 

Ms. Kaiserman has allowed us to reproduce her slide presentation.  Click link to  Download Bet Tzedek Presentation on Estate Planning Basics 7.8.2019.

Our faithful correspondent, who hastens to note that she is not an attorney, also filed the following report based on her notes from the program:

- A  first responder (i.e., ambulances) will not pay attention to your Advanced Directive, but to your POLST form if you have one. Have one displayed prominently.

Advanced Health Care Directive - (a/k/a Living Will)

- allows decisions to be made by another. Only comes into effect when you become unable to do it. Allows the appointment of an agent. The Primary Care physician will be the one to say when the 'agent' needs to step in. Normally 'agents' are family members or friends, someone the patient t rusts and whom  you have made aware of  your wishes. This document needs to be signed by two witnesses. It may indicate what kind of funeral you wish. Some states do  not recognize this document; be aware that  you may need to make another one if you move to a different state.

- Durable Power of Attorney for financial matters. Make sure to give copies of it to your family and/or responsible friends.

    If one of your agents is unwell and unable to continue helping, appoint another 'in succession'/ Also, a previously appointed agent may decide not to continue, you need to have a backup. If you do not have an agent when the need arises, guesses would have to be made as to how to proceed.

- The ER Doctor - should have a copy of your POLST form.

- In Hospitals -  important to have a copy of your documents available there. In Catholic  hospitals, the default decision would be to save lives... making sure that  your DNR is respected may be m ore difficult; check with them when possible

- Conservators -

If one is needed because of mental  health problems (dementia... strokes) , more than one doctor needs to be involved; this is not easy to accomplish. One has to go thru the courts to obtain a conservatorship.

conservatorship is more extreme than immediate power of attorney as one is suddenly made unable to handle one's financial affairs.

- Power of attorney for finances

gives someone the authority to manage one's finances, such as real estate, bank account, taxes, benefits, litigation... This is a very broad coverage and can be abused. Be very careful whom you chose. Your  house could be sold under you!  In California you can authorize one or all of the powers.  Elder abuse can take place. Only give the amount of power  you absolutely need to give.- there are two kinds of these powers of attorney for finances, a durable one and a  non durable one. One can also  put a limit as to the duration of this document: immediate or limited. 'springing', i.e. not now, just conditional.

You want to avoid being kicked out of your  house while  you are still alive!!!!

Most Trusts include a power of attorney; usually this power is given to the successor Trustee.

(Durable power of attorney)  -

 - technically,  the patient can still somehow act on his/her own. Conservatorship is clearer, more absolute.

meanwhile, if you still have mental  capacity  but  need help, you might want to consider a financial advisor.

WILLS AND TRUSTS

both handle the distribution of property after one dies. A handwritten will, signed and and dated, is valid in California.

Wills are only about property.

(Bet  Tzedek does not write wills that disinherit someone...)

Trusts - are a good idea, rather than Wills, if you own your residence, for instance.

   - some 'non probate' items do not go into Wills or Trusts.

  - 'joint tenancy' items will go to the named individuals.

some terminology: Settlor =  the person who creates the Trust.

                               Trustee = the person who  manages  the Trust.

                               Successor Trustee - manages the  Trust when the Trustee is unable to, because of illness or death.

BE CAREFUL in your choice of Trustee as a poor choice could abuse his/her power and/or have ulterior motives.

EVERYTHING goes into your Trust.

TODD =  Transfer On Death Deed - an alternative to a Trust; indicates 'after death'..

   - IRAs, retirement plans, etc. are treated separately.

.......................................................................................................................................................................................................................

answers to some questions by the audience:

- yes, there is a difference between a successor trustee and an executor; the first one is when one has a Trust, the second applies to a Will.

- yes, the State of California recognizes Trusts from other states.

- do you have a small estate? a Trust will still avoid probate.

 

Estate Planning Basics - July 8 - 10:30 a.m. - Library - followed by lunch

 

Please come to Palisades Alliance for Seniors' July 8 program, titled "Estate Planning Basics."  Our speaker will be Dani Kaiserman, Staff Attorney, Elder Justice Unit, Bet Tzedek Legal Services.

Ms. Kaiserman will present a brief overview of advance planning, including health directives,  financial power of attorney, wills, non-probate transfers, trusts, and transfer-on-death deeds.

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon. Attendees are invited to stay and socialize after the program over a light lunch on the library patio, offered courtesy of a grant from the Palisades Woman’s Club.

Report on June 24 bone health program

This was a very informative program.  Our speaker, Dr. Singer, is letting us post his presentation here. Click link to Download Bone Health Presentation 6.24.19.

Following is our steadfast correspondent's takeaway from the program:

Osteoporosis is a metabolic bone disorder, characterized by a gradual decline in absolute bone  mass, with preservation of the skeletal mineralization  process.

It is a worldwide problem, as the microdeterioration of bones can lead to fractures of these fragile bones.

 

Starting in the 80s one started measuring bone density with a small amount of radiation. In the Dexa test (dual energy x-ray absorptiometry), two x-ray beams are aimed at the bones. It detects weak or brittle bones and can be repeated to compare the progression of bone loss. It is recommended that all women over 65 and men over 70 have a Dexa test at least once. (the age discrepanpy is because bone loss in women is associated with a decrease of  estrogen after menopause)

Only use recommended/well known test sites.

- (the QCT test, less common, is performed on a CT scanner)

 

Around age 50, the ovaries slow down and finally stop fonctioning, causing  menopause. 

the loss of estrogen creates a decline in bone  mass and may cause fractures to occur. This will create a large decrease in physical activities, later on possible problems with breathing, digestion  and depression.

 

- an expensive complication is hip fractures. 90% of these come from falls, but a handful of them comes from a spontaneous break in the hip bone, and a consequent fall.

 

osteoporosis can also be genetic; being aware of your family history is helpful as preventive treatment may then be instigated.

 

if you take estrogen, you don't lose bone density; but there are side effects associated with estrogen.

In men, testosterone gets converted into estrogen. in older men, testosterone levels decrease. If men are given estrogen, their breasts get larger.

 

- in general, low body weight and/or anorexia causes a decrease in bone density; maintaining one's  bone density is very important.

 

Avoid cigarette smoking, recreational drugs and excessive alcohol drinking as these inhibit bone density!

a high dosage of thyroid hormones also leads to bone loss.

 

Exercise is very important as strong legs help to  prevent falls; it is also good for the brain and  mental state, but does not cure osteoporosis.

( a two weeks bed rest creates changes in one's skeleton; a young polio patient has smaller bones forever)

 

Vitamins and Supplements

 

recommended: Vitamin D - (it is formed in the skin when it is exposed to direct sunlight). 10 minutes a day of sun exposure, three times a week, provides enough Vitamin D. Too much sun exposure, of course, could cause cancer.

- if taken in  pills, about 1,000 units a day is recommended. If overweight, it is advised to use up to 4,000 units a day. (cancer patients, and depressed people have a very low level of vitamin D in general)

Vit D needs a  prescription.

 

Calcium

 

Too much calcium can cause kidney problems. three glasses of milk a day would bring enough calcium.

It can also be taken in  pills:

 

- Calcium carbonate (Caltrate, Tums) has a higher amount of calcium -  40%; it can be taken with meals to help dissolve properly

- Calcium citirate  (citracal) dissolves more easily, but contains less calcium - approx. 29%

1,000 mg of calcium is recommended daily.

 

How to maintain postmenopausal bone  health

 - estrogen is the  most  natural way, but it seems that, in general 'the jury is still out' on its safety. An estrogen patch is preferable.

 

Calcium, Vitamin D,  exercise are ok, but not enough.

Biphosphates stop bone loss and stay in bones for 3 to 5 years. Their usage has significantly decreased in the past few years, due to negative publicity in the press about side effects. They may create stomach upsets and heartburn. It is recommended to take them with a tall glass of water on an empty stomach and  to not lie down or bend over or eat for 30 to 60 minutes to avoid the medicine washing back into the esophagus; then eat to neutralize the remaining medication.

 

- intravenous biphosphates can cause flu like side effects.

Boniva can be  injected every three  months; Reclast once a year.

 

For exact/fully dependable  information on all  medications, please consult the slides provided by our presenter.  Click link to Download Bone Health Presentation 6.24.19 .

"Bone Health in Older Adults" - June 24 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' June 24 program, titled "Bone Health in Older Adults."  Our speaker, Frederick R. Singer, M.D., will discuss the nutritional needs, exercise and possible medications needed to maintain bone health.

Dr. Singer is Director of the Endocrine/Bone Disease Program at the John Wayne Cancer Institute at Providence Saint John’s Health Center, Santa Monica, California and is Clinical Professor of Medicine at David Geffen School of Medicine at UCLA.  He is a member of the Board of Trustees of the National Osteoporosis Foundation. 

He received his MD degree from the University of California School of Medicine, San Francisco in 1963. He completed his postgraduate training in internal medicine at the University of California Affiliated Hospitals, Los Angeles, followed by research fellowships in endocrinology at the Royal Postgraduate Medical School, London and the Massachusetts General Hospital, Boston, Massachusetts. He has served on many national public health committees, and on the editorial boards of multiple journals.

Dr. Singer's research interests are skeletal complications of malignancy, Paget’s disease of bone, primary hyperparathyroidism, osteoporosis and the effect of vitamin D on breast cancer and malignant melanoma.

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. 

Report on June 10 palliative care and hospice program

This presentation by Jeannie Meyer, UCLA's clinical nurse specialist for palliative care, was very well received.

Ms. Meyer kindly agreed to share her Powerpoint slides.  Click link to Download Palliative Care and Hospice Presentation 6.10.19.

Our faithful correspondent attended the program and filed the following report:

   Few people devote much thought to how they might live with a serious or life threatening disease or how they will die. Most do not make ad equate plans to ensure that their wishes will be followed.

 

a Living Will allows a person to explicitly state his wishes regarding health care in the  event he can no longer speak for himself.

 

a Durable Power Of Attorney for Health Care authorizes a specific person to make health  care decisions  for a person who can no longer speak for himself.

 

a Polst Form will record the patient's specific  wishes in the form of  medical orders. It is a pink form  that - it is suggested - should be kept on one's refrigerator door, so as to be easily located by first responders. It is suggested also that a copy be  made and be kept in one's purse. These instructions are legally binding.

 

There are also religion-specific advanced directives. These will also be equally  honored.

 

(if these instructions do not exist, problems can arise as family members may make decisions the patients would not have agreed to)

 

PALLIATIVE CARE

 

  The term comes from Latin, palliare - to cover. It is offered to people with life threatening (incurable) diseases to help them live longer - and provide comfort.

Any major hospital offers this service  now, some specialize, for instance, on  cancer care.  (in the mid 80s there were large groups of patients receiving this type of care).

a team (physician, nurse, chaplain, social worker) is at  work there.

 

HOSPICE CARE

 

  As defined by the benefit provided by Medicare, it is reserved exclusively for patients expected to die within 6 months.

Doctors,  nurses, nurses' aides, social workers form the core of a hospice team. This team may also include  nutritionists, psychologists, chaplains, volunteers.

(even specially trained dogs!).

 

  The care is provided either at the patient's home or in an  inpatient facility. Hospice care also involves assistance to patients' families to help them cope.

 

- The main guardians are the family care giver and a hospice nurse who  makes periodic stops.

 

- It is the only Medicare benefit that includes pharmaceuticals, medical equipment, 24 hour/7 days access to care, support for loves ones following a death...

 

- It  is also covered by Medicaid and most private insurance plans.

 

Hospice care may involve not treating illnesses.

 

selection of hospice providers -

  There are computerized check lists indicating the hospice's particular 'philosophy', whether it is non profit or not, religion affiliated or not...

   It is suggested to interview several to find a good fit.

 

(Strokes... this can be a reversible condition if treated quickly. In the area, UCLA Westwood is the closest treatment center.)

"Palliative Care & Hospice: Help and Guidance on a Difficult Journey" - June 10 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' June 10 program, titled "Palliative Care and Hospice: Help and Guidance on a Difficult Journey."  Our speaker will be Jeannie Meyer, the Clinical Nurse Specialist in Palliative Care at UCLA Healthsystem.  

For patients with chronic, irreversible and often terminal illness, life can become a challenging journey filled with uncontrolled symptoms, confusing therapies and difficult decisions.  Palliative care can offer a helping hand throughout this journey by providing management of complex symptoms, assistance with advance care planning, and support for the patient and loved ones. 

When the journey approaches the end, hospice offers additional support to allow the patient to maintain their greatest level of comfort and function.  Throughout the challenging journey, both services focus on quality of life and individualized care. 

This presentation outlines the services offered by both palliative care and hospice; additionally Ms. Meyer will discuss advance care planning, including Advance Directives and POLST forms (Physician Orders for Life-Sustaining Treatment) and when each document is appropriate. 

Ms. Meyer obtained her BSN and MSN from University of Texas Health Science Center in San Antonio and has been a Clinical Nurse Specialist since 2000, with national certifications in Critical Care, Progressive Care and Palliative Care.

"Dementia Friends" - May 20 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' May 20 program, titled "Dementia Friends."  Our speaker will be Dick Williams from the Alzheimer's Greater Los Angeles Speakers Bureau.

Dementia Friends is a global movement that is changing the way people think, act, and talk about dementia.  Developed by the Alzheimer’s Society in the United Kingdom, the Dementia Friends initiative is underway in California and across the United States.  By helping everyone in a community understand what dementia is and how it affects families, each of us can make a difference for people touched by the disease.

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon

Report on May 6 pelvic floor disorder program

For those who were not able to attend this outstanding presentation, Dr. Cadish has kindly agreed to let us make her slides and handout available here.

Click link to  Download Cadish pelvic floor disorder handout. 

Click link to Download Cadish Pelvic Floor Disorder presentation .

Below are notes taken by our faithful scribe.  (The scribe entreats readers to note that she is not a medical specialist and so cannot be certain that her transcription is faithful to the speaker's words.)

-------------

 

 Our speaker, Dr Lauren Cadish is a uro-gynecologist. i.e. specializes in treating the pelvic floor disorders. She is also a surgeon.

 

Pelvic floor disorders affect particularly (but  not exclusively) older women and are the source of a  multitude of vexing and embarrassing problems such as organs' prolapses (bladder, uterus, rectum) and urinary incontinence.

 

This happens because the muscles, connective tissue and ligaments that keep the organs in place weaken over time. Lack of estrogen, damage to the pelvic muscles and  nerves from childbearing and prolonged labor, chronic constipation, heavy lifting, frequent coughing and sneezing can also cause pelvic support disorders; obesity may be a factor as well.

 

Patients often think that they are the  only ones with these troubling conditions that may include urinary incontinence and or/leaking.

 

Medicare covers treatments.

 

Non Surgical Treatments

 

Pelvic floor physical therapy, done under  the supervision of a specially trained therapist, may help strengthen the pelvic floor.

 

Kegel exercises can also be done. However, finding the right muscles to squeeze  can be difficult.

 

Pessaries are helpful. They help hold the vaginal wall; the knob will fit behind the urethra and help stop urine flow. They need to be carefully chosen and should be comfortable.  Many patients can insert and remove them. They can be  removed  for sex. They need to be  monitored, however, as small ulcerations could take place.

 

Injections of botox in the bladder. meed to be repeated at  intervals.

 

Acupuncture type, percutaneous, thru the ankle, once a week, for 12 weeks (interstim Medronic); somewhat effective.

 

Surgeries

 

injection of a substance - a filler - in the urethra. The  material will last 6 to 9 months. This procedure can be done in the doctor's office.

 

a mid urethral sling procedure - can be done in the doctor's office - under anesthesia. A hammock like sling will lift the urethra and bladder  neck to prevent leaks. This is an outpatient procedure but will need some recovery time at home and precautions with lifting. the patient will go  home afterwards.

 

Some women are sentimental about their uterus. However, if the uterus is removed, one can access above it.

the vagina could also be closed off from below.

 

Urgency incontinence

(overactive bladder)

 

The bladder - a balloon - is surrounded by a muscle that - ideally - squeezes when we need it to. We can originally control that  muscle. But, aging of the bladder muscles can decrease the bladder's capacity; also, involuntary contractions become  more frequent with age. Menopause helps deteriorate the lining of the bladder.

 

One first line of defense can be to avoid alcohol, acidic foods and drinks, reduce liquid consumptions. One can also try some bladder retraining, 'go' every 30 minutes, e very 40  minutes, etc.

 

Weight control - a  moderate weight loss does help.

 

Medications:

- a special patch can be purchased without a prescription.

- pills, once a day, from low to high doses; try and see which dose will work best. However, these anticholinergics may c ause dry eyes and mouth and constipation.

 

A recent medication, Myrbetriq - a beta-3 adrenergic receptor agonist that causes relaxation of the detrusor smooth  muscle of the urinary bladder and increases bladder capacity seems to work well, without side effects. However, it is expensive and may not be covered by one's insurance.. (I found a price of  $410 for 30  tablets of 25mg)!

 

The above medications, to be effective, need to be taken not when as  needed, but regularly so that there is always some of it in the blood.

 

A coping option: an app: RunPee.com

 

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Some questions from the audience?

 

Q- How does one chose one's doctor, according to his/her results?

A- This is  not easy as long term results are difficult to register. This is a field in its infancy  now.

one  normally relies on recommendations from friends and family ane one's doctor's.

--------------

Q- Ovarian cancer: How can one catch it on time?

A- Very difficult as it  normally does not have any symptoms till it is often too late...

----------------

 

Q-  Rectal leakage?

A - changing one's diet will change what is coming out... sometimes the new diet will take care of the problem.

 

rectal prolapse needs to be treated by a rectal surgeon

----------------

 

Q - How efficient is  physical therapy for incontinence?

A - It depends on the reason for the incontinence and the frequency of that incontinence. Physical therapy will help, improve, but will  not cure the problem.

-----------------------

 

Q- How about estrogen?

A- Estrogen, pill or patch, does not help with prolapse or incontinence.

 

However, estrogen cream, applied locally in the vagina (or a ring or pill) can be quite  helpful to prevent vaginal infections, will keep the vagina healthier. also it is very low risk - if even risk free - for cancer patients.

 

"A Problem 'Down There': Pelvic Floor Disorders Demystified" - May 6 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' May 6 library program, titled "A Problem 'Down There': Pelvic Floor Disorders Demystified."  Our speaker will be Lauren A. Cadish, M.D., FACOG.

Dr. Cadish is a urogynecologist at Providence Saint John’s Health Center in Santa Monica. She is board certified in Obstetrics and Gynecology as well as in the subspecialty of Female Pelvic Medicine and Reconstructive Surgery. She is a graduate of the University of Chicago Pritzker School of Medicine, after which she pursued residency at Beth Israel Deaconess / Harvard Medical School and fellowship at UC Irvine Medical Center. Her research has been presented at national and international meetings and published in multiple highly regarded medical journals. She has never been a consultant for any device or pharmaceutical company.

Pelvic floor disorders have been referred to as a hidden epidemic affecting a large proportion of women, the prevalence increasing with age. Symptoms can be embarrassing and frustrating. Dr. Cadish will discuss both pelvic organ prolapse (the falling of pelvic organs into the vagina) and urinary incontinence and explain diagnosis and treatment options.

The free program will take place in the Palisades Branch Library's Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades.    For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event. 

Report on April 22 program on fire safety and disaster preparedness

This was an extremely valuable program, presented by Captain John Ignatczyk, the LAFD's disaster preparedness officer.  Unfortunately, our erstwhile notetaker was not available to take notes.  However, there is considerable disaster readiness information available here on the Community Council's website.  

Also, those who were not able to attend may be interested in attending the upcoming Community Fire Safety Meeting taking place in the the Paul Revere Middle School auditorium next Tuesday, April 30 from 7:30 - 9:00 p.m.  Here's the Community Council's write-up about it: 

This informative meeting -- organized by LAFD, LAPD and Brentwood residents -- will include a Power Point presentation on fire preparedness and safety by LAFD WLA Deputy Chief Armando Hogan, along with a panel discussion featuring experts from LAPD, LADWP, LADOT, Emergency Management (communications), My Safe LA (protection/evacuation of aged & disabled persons), Animal Services and Recreation & Parks. Councilmember Bonin will be there to answer questions, and representatives from Assemblymember Bloom's office will also provide information about fire insurance. Palisadians are encouraged to attend.

"Fire Safety and Disaster Preparedness" - April 22 - 10:30 a.m. - Library

Please come to Palisades Alliance for Seniors' April 22 library program, titled "Fire Safety and Disaster Preparedness: Know What to Do."  Our speaker will be LAFD Captain II John Ignatczyk, Disaster Preparedness Officer.

Preparation and organization can make a big difference when dealing with fires and other catastrophes. Captain Ignatczyk will discuss how to stay safe by protecting, preparing, and planning.

The free program will take place in the Palisades Branch Library's Community Room, and run from 10:30 a.m. to 12:00 noon. Attendees are invited to stay afterward and socialize.  The library is located at 861 Alma Real Drive in Pacific Palisades.    For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event. 

Book recommendations from April 1 program on mindfulness

Click here for a list of the mindfulness books recommended by our April 1 speaker, Rosemary Alden.

 

"Hey, Where'd the Time Go? Living with Peace, Joy, and Satisfaction for the Rest of Your Life"

Please come to Palisades Alliance for Seniors' Monday, April 1 library program, titled  "HEY! WHERE'D THE TIME GO? Living with Peace, Joy, and Satisfaction for the Rest of Your Life." Our speaker will be Rosemary Alden, M.A., M.F.T. 

The senior years come as quite a surprise! Are you ready, or not? How can we enjoy these well-earned ‘sunset years’ when the past seems unfinished or we’re worried about the future? Capturing life’s joy is about living fully in the present moment. As we age, the challenge is to learn how to translate our fears, concerns and experiences with insight and newfound perspectives that can lead us skillfully forward.

Rosemary Alden's ability to guide others through this process is based on the knowledge that the only constant in life is change. Change often means dis-ease. But suffering is not inevitable. This yet-to-be-discovered path can be filled with ease, optimism, understanding, compassion and gratitude.

Rosemary is a mindfulness teacher and psychotherapist in private practice. Her goal is to inspire others to reflect on their lives as they navigate life’s transitions. She works with individuals, families and groups drawing from studies in Western psychology, Eastern and Native wisdom, meditation practices, and a great deal of life experience. She is a mother of five and grandmother of eight.

The program format will consist of a conversation-style discussion with the audience. During the program Rosemary expects to respond to individuals' questions and concerns that have been submitted in advance and/or shared at the gathering. In this way one may gain direct help or learn while listening to another’s experience.

To invite Rosemary’s response to your personal issue, please write several sentences about it and submit by March 30 to Palisades Alliance, via snail mail at P.O. Box 1082, PP 90272, or via email to palisadesalliance@gmail.com. If you wish to be in public conversation please do make sure to give your name. (Note: Because of time limits Rosemary may not be able to address all questions.)

The free presentation will take place in the Palisades Branch Library's Community Room, and run from 10:30 a.m. to 12:00 noon. Attendees are invited to stay afterward and socialize. The library is located at 861 Alma Real Drive in Pacific Palisades.    For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event. 

Report on March 11 understanding hoarding program

 

The crowded room was spellbound as L.A. County Hoarding Task Force leader Christina Nairn returned to help us understand the staging and psychological underpinnings of hoarding disorder.   

Ms. Nairn agreed to let us post her slide show here. Click link to Download March 11 hoarding disorder presentation.

Following is a report from our erstwhile correspondent:

The presentation on hoarding by Christina Nairn, LCSW was extremely  detailed and informative.

 

The hoarding disorder, as described in DSM-5,  is characterized by difficulty discarding or parting with possessions regardless their actual value as well as, in most cases, persistent acquisition of objects. Possessions are accumulated in large numbers that fill up and clutter active living space to the extent that its intended use is no longer possible,   resulting to significant functional impairment and/or distress'

 

Although hoarding affects only between 2 and 5 percent of the population, it is associated with psychiatric symptoms in 75% of the cases, prevents access to medical care and leads to depression, anxiety and isolation.

 

Problems start around 10 to 15 years of age, rarely after 40, but affect seniors more severely.

 

Hoarding is particularly of concern to our seniors for the following reasons:

 

- there is less ability to leave home, leading to isolation  and loneliness.

 

-  the  hoarder may need a home health aide but does not feel comfortable, may even be ashamed to  let anyone into their messy/cluttered  homes  and or may lack the organizational skills to get to a doctor or to follow through with recommended treatment.

 

- the home may be so cluttered that it is difficult to walk in it, much less use a walker that may be needed.

 

- multiple sores may be caused and left untreated because of possible falls.

 

- medications may be disorganized, and mixed with older ones and/or lost.

 

- it may be difficult or even impossible to shower as access to it may be compromised.

 

- the bed may not be accessible as it may be piled with books or magazines.

 

- windows may never be opened, may become inaccessible, may be covered.  no clean air!

 

- there may be pest infestation and fire risk because of difficulty cleaning.

 

- in the kitchen, there may be no available place to cook, no place on the cooking space or too close proximity of clutter - causing a fire hazard; refrigerator may  not be operational, causing food to waste or become unsafe.

 

Hoarding is reportedly very tough to treat and early interventions are recommended.

 

There is a peer support group at Wise and Healthy Aging, but it has a waiting list.

"Buried in Treasures: Understanding Hoarding Behavior" - March 11 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' Monday, March 11 library program, titled  "Buried in Treasures: Understanding Hoarding Behavior."

Our speaker will be Christina Nairn, LCSW, Chair of the Los Angeles County Hoarding Task Force and Supervising Social Worker for the L.A. County Department of Mental Health GENESIS Program.

Hoarding is the excessive collection and retention of things or animals until they interfere with day-to-day functions such as home, health, family, work, and social life. Severe hoarding causes safety and health hazards. It is estimated that older adults represent a significant number of people who hoard.

Ms. Nairn will discuss the causes and types of hoarding, what behaviors are and are not considered hoarding behavior, and current interventions that support the person, family, and community.

Report on February 25 program on navigating fairness and equality in estate planning

 

This was a fascinating presentation by Dr. Eileen F. Gallo and Bruce S. Ross, Esq., on balancing the considerations involved in passing wealth on to one's family members, in particular siblings who are caught up in the three "C's" of competition, cooperation, and comparison.

Seventy-one people attended the program, and many stayed afterward for a light lunch courtesy of a grant from the Palisades Woman's Club. 

With the speakers' permission, we are making their handout available here.  Click link to Download Gallo and Ross handout.

Additionally, our steadfast scribe once again took notes on the program; they are provided below:

Sibling relationships are complex, to say the least, even in loving families.  Personalities are different and incompatibilities exist, of course. This is reality.

 

Some siblings communicate poorly, if at all. Money complicates matters. Expectations differ greatly, financial needs too.

 

Siblings can be 'best friends', 'good enough', estranged or cut off...

 

When estranged, there is still hope. Relationships are dynamic, and will change over time, illness and finally death.

'best friends' relationship are too rare.

 

And .... we all remember definite moments of parental fairness of unfairness in our childhoodsand grow up with different perceptions of our treatments by our parents.

 

When transmission of wealth takes place, after a parent's death, there may still be competition for the love and attention of our parents. 'Mom loves you best'! ..

 

Cooperation is needed in handling inheritances. One also needs to follow state laws.

--- What is fair? so many variables exist in each situation = birth order, special needs, addiction problems, illness, death of another family member, economic disparity, age difference.. One may feel penalized because of one's financial success.

 

Good communication is a MUST

 

One in five older Americans said that inheritances  are a source of bad feelings...

some feel that parents were unduly influenced by one or two siblings...

however, 82% found that division of property was all in all fair.

still, it is a good idea to explain in one's will or trust why the estate is not equally distributed, if this is the case.

 

A suggestion: to write each child a loving letter, expressing all the positive feelings one  has toward that child..

 

(if one makes a loan to a child, while still alive, one should charge some interest, in fairness to others).

 

and one can, of course, gift part of one's estate while still alive; $15,000 a year is tax free, to as many persons as one wants.

"Mom and Dad Loved You Best: Navigating Fairness and Equality, Real and Perceived" - February 25 - 10:30 a.m. - Library

Please come to Palisades Alliance for Seniors' Monday, February 25 library program, titled "Mom and Dad Loved You Best: Navigating Fairness and Equality, Real and Perceived.” 

Our speakers will be Eileen F. Gallo, Ph.D. and Bruce S. Ross, Esq.  Dr. Gallo is a licensed psychotherapist who works with individuals, families, and financial advisors concerned about the psychological and emotional issues of family wealth. Mr. Ross is a mediator and arbitrator who has decades of experience as a trial lawyer specializing in trust, estate, and financial elder abuse litigation.

You can pick your friends but you can’t pick your family. Siblings are stuck with each other whether they like it or not. Parents generally want to treat their children equally and do not want them to squabble over the family inheritance. The speakers will use real life examples from their practices to explore methods of successfully resolving intra-family conflicts relating to the transfer of wealth.

The free presentation will take place in the Palisades Branch Library's Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades.   For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event. 

Report on February 11 home modification program

 

For those inspired to take action after Leon Willis Watts III's presentation, Mr. Watts suggests consulting USC Home Modifications Website's Resources page, which has a wealth of useful information on products to consider, links to informational websites, and more. 

Mr. Watts followed up with this generous letter directed to audience members: 

 

“Age friendly home modifications” is a good title, but home mods is not an easy notion for most people to wrap one’s mind around or act upon, without help.

But statistically, most people want to age in place, and most homes are not totally ready to offer a totally safe environment without some modifications.

I wanted your audience to make themselves open to being mentally and emotionally prepared to tackle getting their homes in the safest and best condition possible to age in place. After they do what they can to de-clutter, then use these suggestions to start.

My suggestions for approaching the task are as follows.

(NOTE: For the next 30 days, for people who were at the meeting and make their list, I will make myself available by email at leonwatts3@gmail.com for questions and answers to help them start acting on accomplishing their goals.)

First, click link to Download Home Fall Prevention Checklist. 

Then: 

1. Homeowners should walk around their house and make a list of concerns and questions about their home, products and services they want.

2. Get a friend or family member they trust to look at their list and help them with their search for products and services online. As I mentioned at my presentation, this would make a great group exercise. This will help give you an idea of cost. This can make your list a real plan to act upon.

3. Find a contractor or handy-person in their area who has training or experience in modifications for older adults’ homes.

Remember you can email me for help over the next month. 

Congratulations for taking on this project to make your homes the best they can be for aging in place !

        Leon

 

"Home Modification - February 11 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' Monday, February 11 library program, titled "Home Modification.”  Our speaker will be Leon Willis Watts III. 

Mr. Watts will discuss why home modifications are important, and how to accomplish what is needed to age safely in one’s home for as long as possible.

In 1979, Mr. Watts opened his home repair and major modifications management company, Guardian Home Services. Most of his clients at the time were in their forties and fifties. As time passed and his clients aged, they began to ask him to help them manage their personal business and help them to successfully age in their own homes. These requests led Mr. Watts to return to USC at age 62 to get his masters degree in Gerontology, to learn how he could better serve his clients. 

Mr. Watts is now a Learning and Development Specialist with USC’s Davis School of Gerontology, where he teaches an online course called “The Ethics of Home Modifications.”   Alongside his work at USC, he continues to manage clients that are over 80, to help them remain as independent as possible in their homes. He is also working to develop a cadre of various types of professionals who can help aging adults and their families with life tools, reliable information, and assistance.  

The free presentation will take place in the Palisades Branch Library's Community Room, and run from 10:30 a.m. to 12:00 noon. Attendees are invited to stay afterward and socialize. The library is located at 861 Alma Real Drive in Pacific Palisades.    For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event. 

Report on January 28 safe driving program

The DMV's Senior Ombudsman Tressa Thompson returned for a second year to answer 55 attendees' questions, primarily about the new RealID card and about the DMV's license renewal requirements for senior drivers.  

All of the information that Ms. Thompson provided is available online at the DMV website's Senior Driver Portal.

You can click the following link if you just want to Download DMV Senior Guide for Safe Driving.  View that Guide online here. 

Ms. Thompson's direct phone number is (310) 615-3552.

"Seniors and Safe Driving" - January 28 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' Monday, January 28 library program, titled "Seniors and Safe Driving.”

Our speaker will be Tressa Thompson, Senior Driver Ombudsman at the California Department of Motor Vehicles. 

The DMV’s Senior Driver Ombudsman Program was established to help all drivers maintain their driving independence for as long as they can do so safely. The Senior Driver Ombudsman Program strives to address specific concerns of senior drivers, including education and training, and to assist as a liaison to ensure that senior drivers are treated fairly and consistently when faced with changes in physical, visual and/or mental abilities.  

The free presentation will take place in the Palisades Branch Library's Community Room, and run from 10:30 a.m. to 12:00 noon. Attendees are invited to stay afterward and socialize. The library is located at 861 Alma Real Drive in Pacific Palisades.    For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event. 

Report on January 14 memory loss and Alzheimer's program

Fifty-five people braved the rain to learn about memory loss, dementia, and Alzheimer's.  The presenter, Kimiko Kelly of Alzheimer's Los Angeles, had the audience's full attention.  Ms. Kelly kindly agreed to make her Powerpoint presentation available to us here. Click link to Download Memory Loss and Alzheimer's presentation.

Our faithful correspondent attended the program, and filed the following report: 

What is Alzheimer's?

 

"A progressive neuropsychiatric disease of aging found in middle-aged and particularly in older adults,  affecting brain matter,  and characterized by the inexorable loss of cognitive function as well as affective and behavioral disturbances." it is a major public health issue. It is frequently referred to as senile dementia.

 

Tangles appear on the brain and spread  (see www.aboutalz.org.)  eventually leading to complete disability. One will lose the ability to  make plans, lose control over moods and feelings, possibly have hallucinations, develop  balance and coordination problems, experience breathing and  swallowing problems... The full development of the disease may take from 8 to 10 years.

 

At 85 years old, 1 out of 3 has the disease.. Gender: a bit more in women, maybe because women in general live longer.

 

At first, retrieving information becomes more difficult; the patient  becomes confused,  has  trouble reading or writing. Paying bills becomes a chore; confusion as to time and day arises; one asks repetitive questions, repeats stories; loses more things than normal; may accuse others of theft.

- If the  patient is agitated or argumentative, don't argue back. Also, and this is paramount, an Alzheimer's patient should not be left alone as he/she may get lost easily.

 

However, many reasons exist for memory loss and/or confusion: medications, diabetes, blood pressure, anxiety, stress, depression, alcohol, smoking, blood clots, tumors, head injuries, infection, dehydration, lack of sleep, isolation, lack of interesting pursuits, poor socialization... these may be temporary. One needs to find out if this might be Alzheimer.

 

importance of prompt diagnosis

As the disease will progress, and will lead eventually to general disability, finding out early enough will help patients deal with their futures, manage the disease, planning for care, making estate plans, organize resources, etc. A doctor could  help with the differential diagnosis. However, not all doctors are trained to recognize Alzheimer signs.  

 

A definitive diagnosis can only be made from brain tissue obtained at biopsy. Therefore, the diagnosis is  usually made on the basis of history, physical examination, tests, and the exclusion of a variety of other causes of similar mental  manifestations.

 

At this point the disease cannot be cured. but one can take part in medical trials.

research is being done on antioxidants to use in  prevention.

Day-care centers have been established that  provide respite for family care givers and increased socialization for patients....

Caregivers can attend special classes to help handle the stresses.

One can volunteer with the organization, participate  in fund raising.

 

It is not curable. However, treatment is essential since the patient's ability for self care and adaptation depends on CNS (central nervous system) function.

"Memory Loss & Alzheimer's" - January 14 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' January 14 program, titled "Memory Loss & Alzheimer's."

Our speaker will be Kimiko Kelly, MPP, Community Education Manager at Alzheimer’s Los Angeles. Ms. Kelly will  provide an overview of Alzheimer’s disease and discuss the causes of memory loss and how to get a diagnosis.  Come learn about the difference between normal aging and signs of dementia, and what to do when you see warning signs.

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

Palisades Alliance, in conjunction with the Palisades Branch of the Los Angeles Public Library, offers programs of particular interest to seniors. 

Report on December 17 holiday memories program and lunch

Our December 17 program was held at the Pacific Palisades Woman's Club so that we could enjoy a holiday lunch (generously funded by a grant from the Woman's Club) after the morning presentation.    We lost some attendance in the transition to the Woman's Club, but the forty-five guests had very good reviews for the interactive program bookended by memoir-writing advice from writer Dana Stevens. 

Following the morning program, guests enjoyed a delicious tamale lunch catered by Rosa Nunez and served by a terrific group of volunteers.  Wonderful music was provided by jazz duo Harrison Korff on sax and Ramtin Rastegar on piano.  

              

"Sharing Your Personal History: Holiday Memories" - December 17 - 10:30 a.m. - Palisades Women's Club - PLEASE NOTE VENUE CHANGE!

Please come to Palisades Alliance for Seniors' December 17 program, titled "Sharing Your Personal History: Holiday Memories," followed by a free lunch with musical entertainment.

In a change of venue, this program will not be held at the Library. Instead, we will meet at the Pacific Palisades Woman’s Club, 901 Haverford Avenue in Pacific Palisades. Parking at the Woman's Club is free, but limited, so do allow extra time in case you need to find street parking.

The formal program will run from 10:30 a.m. to about 12:00 noon. Attendees are invited to stay afterward to socialize over lunch provided through a generous grant from the Woman's Club.  Musical entertainment on sax, clarinet, and piano will be provided by Palisades HS graduates Harrison Garff and Ramin Rastegar, both now music students at UCLA.

To help in food planning, please RSVP for the lunch by calling (424) 260-6167.

As family and friends gather for the holidays, seniors are often asked to share their personal histories. For this program, we bring back screenwriter Dana Stevens, who hosted our well-received “Writing Your Personal History” program in July. Ms. Stevens will show us tips on how to dive in, inspire our memories, and keep the process going.

Please bring with you one photograph to use as a jumping-off point to tell a holiday-related story or a memory, and plan to share that memory in our small story-telling groups. The photo can signal a small story or large event, and you can provide the details to make it come alive.  (Don't worry if you can't find a photo...you can share your memory anyway!)

Dana Stevens has written or adapted many screenplays, including "Safe Haven," "City of Angels," and "For Love of the Game.” She was creator and executive producer of the CBS television series “Reckless,” currently streaming on Netflix. She is a regular advisor at the Sundance Institute writing labs, and is currently adapting the best-selling novel “The Nightingale” for Tri-Star Pictures, and a memoir by Matt Logelin entitled “Two Kisses for Maddy” for Sony.

Report on December 3 joint replacement program

We were fortunate to have UCLA surgeon Dr. Adam Sassoon speak to us about hip and joint replacement.  Forty-four people were mesmerized by his presentation.  

Dr. Sassoon's clinic is located at 1250 16th St., Suite 2100.  You can contact him through his Patient Coordinator, Elizabeth, at (424) 259-9872.

While we are not able to share Dr. Sassoon's  Powerpoint presentation due to concerns over patient privacy,  reproduced below are our faithful scribe's notes from the program.   

Program notes:

 Dr Sassoon discussed the two procedures separately, as follows:

 

Hip replacement was originally designed for use in patients over 65 years of age, with severe osteoarthritis. Dr S has done the procedure on a wide range of patients between the age of 12 and 101.

 

Arthritic damage is the most common reason for the surgery. However, there are other reasons such as a break of the femur following a fall or an accident.

 

During the procedure, damaged sections of the hip joint (bone and cartilage) are removed and replaced with parts constructed of metal, plastic and very hard plastic. Dr S prefers to do the procedure thru the posterior aspect of the hip . He mentions a  95% success rate. A prosthetic round ball with replace the round ball of the femur

 

One or two nights in the hospital normally follow the surgery.

Pain management is better now as a new anesthesia is  used at the time of surgery. Opioids are to be avoided because of the possibility  of addiction.

 

His preference is to  send the patients  home, as to avoid possible infection in a rehab facility.

 

About 6 weeks of rehabilitation will normally follow.

 

There is a risk of blood clots in the leg after surgery and it needs to be addressed with the proper blood thinning medication: baby aspirin twice a day; zoralto (avoid Coumadin as it requires regular checks).  Blood thinning medications will be given for up to several weeks. There is also always a small chance of infection and/or dislocation.

 

Contraindications to the procedure include an active infection and neuropathic joint damage.

...............................................................................................................................................................................................................................................................

 

Knee arthroplasty (replacement) has a failure rate slightly higher than the one of hip arthroplasty,  due to the complexity of the knee anatomy.

 

The need for knee arthroplasty can be assessed thru a simple x-ray; normally no MRI needed.

 

Note that too vigorous impact activities, even with the most advanced biomaterials and design,  however, may result in failures after the surgeries over time.

 

.....................................................................................................................................................................................................................................................

 

Questions from the audience:

 

Q - how long is the recovery in a knee replacement surgery?

 

A - Recovery from knee replacement surgery is more tricky than recovery from hip replacement surgery, as it may take up to a year for any leg swelling to disappear.   (Cf. hip replacement surgery, where patients may take up to six months to completely recover.)  Knee replacement also has a lower patient satisfaction rate than does hip replacement.

 

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Q - is metal used in the replacement?

 

A - No, because of sensitivity to it. Oxinium or Al-poly is commonly used.

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Q- How much of the antibiotics will be given?

 

A - One single dose at the time of surgery.

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Q - if there is an infection at the time of surgery?

 

 A - then, everything needs to come out. Revising the surgery, however, will be easier  than the whole original surgery.

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Q - how about steroid injections, instead of surgery, to control pain?

 

A - ok to do, but one needs to do it not more than every 3 months.

 

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Q - how about pre-existing diabetes?

 

A - if  your 'number' is lower than 8, then it is ok to proceed.

 

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Q - what is the cost of the procedure?

 

A - Dr S accepts Medical, Medicare, Workers' comp, other insurances.

 

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Q - how about  replacement of arthritic fingers?

 

A - not yet....

"Joint Replacement" - December 3 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' December 3 program, titled "Joint Replacement."

Our speaker will be Adam Sassoon, M.D., M.S. Dr. Sassoon is an Associate Professor in the Department of Orthopaedic Surgery at UCLA School of Medicine. He is a dual-fellowship trained orthopedic surgeon with expertise in joint preservation/reconstruction and orthopedic traumatology. His current clinical interests include complex primary and revision arthroplasty, open hip preservation surgery, periprosthetic fractures, and young adult/adolescent deformity correction/reconstruction. 

Joint replacement surgery involves removing damaged or diseased parts of a joint—most often a hip or a knee—and replacing them with manmade implants. Dr. Sassoon will explain the procedure and the diagnostic factors that would indicate joint surgery as an appropriate treatment. He will also cover benefits, risks, and what to expect as far as recuperation.

Dr. Sassoon completed his orthopedic surgery residency at the Mayo Clinic in Rochester, MN. While in residency, he also completed a Master’s Degree in Biomedical Science focusing on tissue engineering using adult derived stem cells. Dr. Sassoon then completed an orthopedic traumatology fellowship at Orlando Regional Medical Center and a subsequent fellowship in hip and knee preservation, resurfacing, and replacement at Washington University in St. Louis. Following his training he worked at the University of Washington in Seattle for four years. He recently moved home to Los Angeles to join UCLA.

The free program will take place in the Palisades Branch Library’s Community Room, and run from 10:30 a.m. to 12:00 noon.  The library is located at 861 Alma Real Drive in Pacific Palisades. For ADA accommodations, call (213) 228-7430 at least 72 hours prior to the event.

 

Report on November 19 fall prevention program and introduction to WISE & Healthy Aging

Forty-eight people came out to hear Dr. Miriam Caiden of WISE & Healthy Aging give a brief introduction to the eight-session A Matter of Balance fall prevention class that she will be teaching at the Palisades Library on Wednesday afternoons starting January 16.  That program is free but pre-registration is required.  To register, call Dr. Caiden at WISE & Healthy Aging:  (310) 394-9871, ext. 264.  You can also register through the Palisades Library: (310) 459-2754.

Click link to Download Flyer for A Matter of Balance fall prevention class.

Click link to Download Dr. Caiden's 11.19.18 presentation.

After the fall presentation discussion, the Director of Program Development and Community Relations for WISE & Healthy Aging, Suzanne Peckels, talked about the organization's new OASIS lifelong learning program, and Dr. Phyllis Amaral, Vice-President of Community Based Services, provided information about WISE's therapeutic programs.

For questions about the OASIS program or general questions about WISE & Healthy Aging, contact Suzanne Peckels by email at speckels@wiseandhealthyaging.org, or by phone at (310) 394-9871, ext. 435.

 

"Fall Prevention" - November 19 - 10:30 a.m. - Library

 

Please come to Palisades Alliance for Seniors' November 19 library program, titled "Fall Prevention."  

Our presenter will be Miriam Caiden, MSG, Ph.D., a Master Trainer of Evidence-Based Health Promotion and Disease Prevention Programming at WISE & Healthy Aging.

Falls are the leading cause of death from injury and the most common cause of non-fatal injuries. Many older adults restrict their activities out of fear of falling. Dr. Caiden’s presentation will cover practical strategies, tools, and techniques designed to reduce the risk of falls.

Following the fall prevention presentation, WISE & Healthy Aging’s Director of Program Development & Community Relations, Suzanne Peckels, along with Phyllis Amaral, Ph.D., Vice President, Community-Based Services will provide information on programs and services that Palisades residents can access through WISE & Healthy Aging.

Report on November 5 Medicare program

This was an extremely informative program.  Our speaker, Aileen Harper, patiently walked an audience of 66 people through the complexities of the Medicare system.  

With her permission, we're making her Powerpoint presentation available here.  Click the link to Download 2019 Medicare Updates November 2018.