Never Too Late - November 2021

Never Too Late Para información en Español ver páginas 19 - 21

November 2021 What’s News • Aging in Our Community • Dementia Capable SoAZ • Medicare Open Enrollment • Rights & Benefits: ALTCS Workshop • Caregiving • Health, Aging & Wellness • PCOA Puzzle • Advocacy • Neighbors Care Alliance • Visibility Matters • CareGiver Training Institute • PimaCare at Home

National Family Caregiver Month


Independence. Vitality. Respect.

Inside • Aging in Our Community 3 • Dementia Capable SoAZ 4 • Medicare Open Enrollment; Presentations; Medicare ScamAlerts 5-7 • Rights & Benefits 8 - 9 • Caregiving 10 - 13 • Health, Aging & Wellness 14 - 16 • PCOA Puzzle 17 - 18 • Nunca Es Demasiado Tarde 19 - 21

• Ending Life Well 22 • Advocacy 24 • Neighbors Care Alliance 25 - 26 • Visibility Matters 28 • PACT Study 29 • Featured Artist 30 • CareGiver Training Institute, Healthcare Education by PCOA 31 • PimaCare at Home, In-Home Care by PCOA 32

PCOA Helpline: (520) 790-7262 Administration: (520) 790-0504 Donate: E-mail: Website: Mail: 8467 E. Broadway Blvd. Tucson, AZ 85710 Never Too Late is published by Pima Council on Aging, the Area Agency on Aging, Region II. Material from Never Too Late may be reprinted when permission is given and attribution is used along with ©PCOA 2021. Editor Adina Wingate, (520) 790-0504 Editorial Assistant Jan Baker, (520) 790-0504 Advertising Adina Wingate, (520) 790-0504 Design Consultant Lori Lieber, Lori Lieber Graphic Design Please include a contact person name and phone number with all submitted material. All articles are subject to editing in accordance with technical and policy guidelines but will not be altered in content without permission of the author. Publication of submissions is not guaranteed. Ads are not to be considered as PCOA endorsements of products, services, or individuals. Editorial and Advertising Deadline for Next Issue NOVEMBER 5 2021

On the Cover: Detail from Kimono, Serigraph, 20 x 14 by Irene Clar The Drawing Studio. (Story, full image on inside back cover) Help from PCOA During the Pandemic Due to the prevalence of the coronavirus in our community, we encourage the public to access our services by phone or email whenever possible. Our building at 8467 E Broadway is open for those requiring in-person assistance. We encourage you to call and make an appointment to ensure the right staff are available to assist you. Our building at 600 S Country Club is not currently open to the public. Please call or visit our website frequently for updates, as availability is subject to change as the public health crisis evolves. The best way to access our services, including making an appointment for in-person assistance, is by calling our Helpline between 8:30 AM and 5 PM Monday through Friday at (520) 790-7262 or emailing




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Pima Council on Aging

Aging in Our Community A Message from W. Mark Clark, President and CEO

Honoring Diverse Caregivers November is National Family Caregivers Month - a time to celebrate the contributions of the more than 65 million Americans who are unpaid caregivers to family or friends who are chronically ill, disabled, or aging. In recognition of caregivers in our community, PCOA is providing additional support and resources (read more on pages 10-11). We’re also reflecting on who our community’s caregivers are, and how we can better serve them in ways that are culturally relevant and meaningful to them. Caregiving research and media portrayals have historically centered around white caregivers – primarily white, middle-aged, middle-class women. As a result, many people who don’t meet this description may not see their familial or cultural reality reflected in mainstream caregiving services, and may be less inclined to use them or find them less useful. Currently, nearly 40% of caregivers nationwide identify as Black, Indigenous, or People of Color (BIPOC), according to the National Community Reinvestment Coalition. Within each BIPOC racial/ethnic group, the rates of caregiving are higher than in white demographics. While BIPOC caregivers tend to receive more support from family and friends than do white caregivers, they

also face different challenges. On average, BIPOC caregivers have lower socioeconomic status and are younger. They are also more likely to experience poor physical health, according to a Blue Cross Blue Shield 2020 study. Studies have also found that Black and Hispanic caregivers often feel ignored in medical settings and left out of crucial care discussions by staff. And Asian-American caregivers don’t use professional support services as often as others, likely because of limited culturally relevant services. While most caregivers feel as though caregiving is the right thing to do, BIPOC individuals often see it as an expected part of life that each generation does at some point. For many, there’s no decision to be made about whether to be a caregiver – it is just a role they assume without much conscious thought. In some cultures, the role of caregiving is based on gender and birth order. While white people tend to take on the caregiving role due to feelings of personal responsibility, caregiving is a cultural expectation in many BIPOC communities and families. It's clear that a one-size-fits-all approach to supporting family caregivers will not be effective in meeting the varying needs of our diverse community. PCOA is currently working with a consulting group to further our Inclusion, Diversity, Equity

and Accessibility (IDEA) work in a number of areas, including developing strategies to adapt services to not only be more accessible to BIPOC communities, but to specifically meet their needs. We know we have significant work to do to in this area and are committed to providing services that give every caregiver the support and resources they need for their own wellbeing and that of the person they care for. Being a family caregiver can be difficult in the best of circumstances, and these past couple of years have been especially challenging. This National Family Caregivers Month, we extend our deepest respect and gratitude to all the caregivers of our community. Best wishes for a safe and enjoyable Thanksgiving holiday. In Service,

W. Mark Clark President & CEO

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Pima Council on Aging

Dementia Capable Southern Arizo na

Individuals with Alzheimer’s disease and related dementias are often cared for by their family members or friends with the majority receiving care in their home. Family caregivers of individuals with Alzheimer’s disease and related dementias are sometimes referred to as the invisible second patient. While caring for a loved one is rich and fulfilling, the responsibility and demands of the role can also limit their ability and time to care for themselves. The requirements on family caregivers are substantial, even more so if you are caring for a loved one with Alzheimer’s disease and related dementias and this place them at higher risk for anxiety and depression. It is important not only to recognize the signs of stress but to have a support system in place, a plan to manage your stress and open communication with your healthcare provider regarding your own health and needs. The Alzheimer's Association has outlined 10 symptoms of caregiver stress for caregivers of individuals with Alzheimer’s disease and related dementias, as well as helpful hints on managing stress. 10 symptoms of caregiver stress 1. Denial about the disease and its effect on the person who has been diagnosed. 2. Anger at the person with Alzheimer’s or frustration that he or she can’t do the things they used to be able to do. and activities that used to make you feel good. 4. Anxiety about the future and facing another day. 5. Depression that breaks your spirit and affects your ability to cope. 3. Social withdrawal from friends

6. Exhaustion that makes it nearly impossible to complete necessary daily tasks. 7. Sleeplessness caused by a never- ending list of concerns. 8. Irritability that leads to moodiness and triggers negative responses and actions. 9. Lack of concentration that makes it difficult to perform familiar tasks. 10. Health problems that begin to take a mental and physical toll. If you experience any of these signs of stress on a regular basis, make time to talk to your doctor. Tips to manage stress • Know what community resources are available.

Memory Cafés PCOA is excited to announce that in partnership with Intermountain Centers for Human Development and La Posada we will be launching Memory Cafés in Pima County in the next several months to come. A Memory Café is a warm, welcoming environment for individuals with Alzheimer’s disease and related dementias. They are designed to include caregivers as well (if they are involved), for a shared experience. Additionally, they are helpful for people with all forms of mild cognitive impairment. Each Memory Café is unique, they focus on different aspects to create a distinctive experience for the individual with cognitive decline and their loved ones. Some Memory Cafés invite guest artists or musicians to attend, some offer education about memory changes, while others are just for relaxing and chatting. Memory Cafés can be offered both in person and virtually. It is important to understand that Memory Cafés are not support groups nor are they respite care. They are a place to talk with others who understand what you are going through, to forget your limitations and instead focus on strengths, socialize, and explore something new. All cafés share one goal – to help guests feel comfortable and to know that they are not alone. Stay tuned for more information about Memory Cafés starting in your area.

• Get help and find support. • Use relaxation techniques. • Get moving. • Find time for yourself. • Consider taking advantage of respite care. • Become an educated caregiver. • Take care of yourself. • Make legal and financial plans.

November is National Caregiver Month and while we know that the role of a caregiver is year-round, we encourage caregivers during this month to choose one way to honor and care for themselves with the level of intentionality and commitment they provide to their loved one. Caregiving is a big responsibility and is deserving of all our gratitude and recognition. Thank you for all that you do.

Memory concerns? Call the PCOA Helpline at 520.790.7262 or visit our website to complete a referral form online

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Pima Council on Aging

Medicare Corner 2021 UNDERSTANDING MEDICARE — What You Need to Know Events Hybrid In-person/virtual events

(registration required/limited seating for in-person only) Zoom link for these events:

Thur 11/4 1 – 4 pm PCOA Lupu Building Thur 11/18 1-4 pm PCOA Dusenberry 600 S Country Club 8467 E Broadway Blvd


All participants in these in-person events will be required to wear masks and adhere to PCOA distancing and safety guidelines, regardless of vaccination status. To assure your safety and that of others, depending on the situation with COVID-19 in our community, this event may be canceled or changed from an in-person event to a virtual event. Once registered, you will be notified regarding any such changes, should they occur, and provided with information about how to join the virtual event and additional options.

Virtual Only No registration needed Wed 12/1 1–4 pm Zoom Event

This project was supported, in part by grant number 90SAPG0049, from the U.S. Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official ACL policy 02/05/21

Updated Medicare Plan Comparison Sheets 2022 updates for Medicare Savings accounts, SNP Chronic & Institutional, SNP Dual, Medicare Advantage HMO, PPO, Stand alone Part D, Medigap Premium Call 520.546.2011 Email

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Pima Council on Aging

Medicare Corner

Medicare’s Open Enrollment Period Medicare’s Open Enrollment Period runs October 15 through December 7 and is the time of year when you can make certain changes to your Medicare coverage. You can make as many changes as you need to your Medicare coverage during Open Enrollment. The last change you make will take effect on January 1, 2022. Take action during Open Enrollment to make sure your coverage will meet your needs in 2022. Know the changes you can make during Medicare’s Open Enrollment Period The changes you can make include:

• Joining a new Medicare Advantage Plan or Part D prescription drug plan • Switching from Original Medicare to a Medicare Advantage Plan

• Switching from a Medicare Advantage Plan to Original Medicare (with or without a Part D plan)

Note: Depending on the state in which you live, you may also have rights to purchase a Medigap policy. Contact your State Health Insurance Assistance Program (SHIP) to learn about state specific Medigap rights and options. Review your coverage for 2022 Medicare Advantage and Part D plans usually change each year. Make sure that your drugs will still be covered next year and that your providers and pharmacies will still be in the plan’s network. • If you have Original Medicare , visit or read the 2022 Medicare & You handbook to learn about Medicare’s benefits for the upcoming year. • If you have a Medicare Advantage Plan or a stand-alone Part D plan , read your plan’s Annual Notice of Change (ANOC) and Evidence of Coverage (EOC). o Explore other plans in your area. You may find a cheaper plan that meets your healthcare and prescription drug needs. Research shows you can lower your costs by shopping around. o Medicare Advantage Plans have significant flexibility in the supplemental benefits they are allowed to offer their members. This includes the ability to offer benefits to some members that are not directly considered medical care, like nutrition services. This means that there are many factors to consider when comparing Medicare Advantage Plan options during Open Enrollment. Carefully review your plan’s EOC and any other plan materials.

Things to consider when choosing a new plan

Ask yourself the following questions before choosing a Part D drug plan : • Does the plan cover all the medications I take? • Does the plan have restrictions on my drugs?

o Prior authorization means that you must get approval from your Part D plan before the plan will pay for the drug. o Step therapy means that your plan requires you to try a cheaper version of your drug before it will cover the more expensive one. o Quantity limits restrict how much of a drug you can get per prescription fill. • How much will I pay for monthly premiums and the annual deductible? • How much will I pay at the pharmacy (copay/coinsurance) for each drug I take?

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Pima Council on Aging

Medicare Corner

Things to consider when choosing a new plan (continued)

• Is my pharmacy in the plans’ preferred network? • Can I fill my prescriptions by mail order? • What is the plan’s star rating?

• If I have retiree coverage, will the Medicare drug plan work with this coverage? Ask yourself the following questions before choosing a Medicare Advantage Plan:

• How much are the monthly premiums, if any? • How much are deductible and coinsurance/copay amounts for the services I need? • What is the annual maximum out-of-pocket cost for the plan? • What service area does the plan cover? • Are my doctors and hospitals in the plan’s network? • What are the rules I must follow to access health care services and my drugs?

• Does the plan cover additional health care benefits that are not covered by Original Medicare? • What is the plan’s star rating? • Will this plan affect any additional coverage I may have? • If leaving Original Medicare and a Medigap for a Medicare Advantage Plan: Will I have the right to purchase a Medigap again later if I switch back to Original Medicare?

Protect yourself from marketing violations and enrollment fraud Medicare has rules about how plans can and cannot communicate with you to market their insurance products. Plans are allowed to send you mail and emails but are not allowed to call or visit you in person without your permission. Here are some red flags to watch out for: anyone who tries to pressure you to join their plan, anyone who claims they represent Medicare and wants to offer free services, or anyone threatening that you will lose your Medicare benefits unless you sign up for a certain plan. If you see any of these red flags or feel you may be experiencing Medicare fraud, abuse, or errors, you can contact your Senior Medicare Patrol (SMP). SMPs can teach you how to spot and protect yourself from potential Medicare fraud. Contact Your SHIP or SMP for Individualized Help Know how to change your coverage You may find it helpful to use Medicare’s Plan Finder tool , which gives you a list of Medicare Advantage Plans and Part D plans, the drugs they cover, and their estimated costs for the year. You can access Plan Finder by going online at or calling 1-800-MEDICARE.

Local SHIP contact information

Local SMP contact information

SHIP toll-free: 520.546.2011 SHIP email: SHIP website:

SMP toll-free: 520.790.7573x2017 SMP email:

SMP website:

This document was supported, in part, by grant numbers 90SATC0002 and 90MPRC0002 from the Administration for Community Living (ACL), Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship are encouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.

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Pima Council on Aging

Rights & Benefits Information ALTCS Workshop

Information for Older Adults with Oxygen-Related Medical Equipment The Medicare program (CMS) recently issued a consumer alert about a large recall by Phillips of a variety of oxygen- related medical equipment, including C-PAP machines and other ventilators. The alert tells consumers what to do if they use this equipment and explains Medicare payment policies for replacement units. Advocates may receive questions from consumers receiving recall notices and the information from Medicare will be useful to share. From Medicare: Philips recently issued a product recall for specific ventilators and sleep apnea devices. If you own or rent one of the Philips products that was recalled, talk to your doctor as soon as possible about whether to continue using your recalled equipment. Get more info here. If you would like to replace or repair your equipment, the supplier you bought the equipment from is responsible for replacing or repairing rental equipment at no cost to you when the equipment is less than 5 years old. If the equipment is more than 5 years old, Medicare will help pay for a replacement. Important: Register your recalled equipment with Philips so they know you need a replacement, and can provide information on the next steps for a permanent corrective solution. To register your equipment: • Visit, or • Call 1-877-907-7508 For more information, see Philips’ Medical Device Recall Notification webpage . C-PAP machines are considered Durable Medical Equipment (DME), a category that encompasses a wide range of devices from complex monitors to wheelchairs and walkers. Advocates wishing to learn more about how Medicare and Medicaid cover DME can read the NCLER Chapter Summary and watch the webinar recording.

Learn about the Arizona Long Term Care System, including what it is, what it takes to be eligible for the program, and what kinds of services are available once a person becomes eligible. A great place to start when you are considering ALTCS for yourself, or for a loved one.

Please join us by computer, tablet or phone. Time: November 10, 2:30 p.m. MST. (Please note the one- time change to Wednesday as PCOA will be closed on November 11th in observance of Veteran’s Day.) Every month on the Second Thursday. Please join ALTCS Presentation on Zoom from your computer, tablet, or phone. Join Zoom Meeting zVHA0MXhwMXBaYmNxaHBGQT09

Or call +1 669 900 9128 US Meeting ID: 813 4345 2577 Passcode: 118666

To register , go to:, or call Donna DeLeon at 520.790.7573 ext. 1750.

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Pima Council on Aging

Rights & Benefits Information

By Jack Burns , Social Security Public Affairs Specialist, Arizona Social Security Announces 5.9 Percent Benefit Increase for 2022 Social Security and Supplemental Security Income (SSI) benefits for approximately 70 million Americans will increase 5.9 percent in 2022, the Social Security Administration announced today. The 5.9 percent cost-of-living adjustment (COLA) will begin with benefits payable to more than 64 million Social Security beneficiaries in January 2022. Increased payments to approximately 8 million SSI beneficiaries will begin on December 30, 2021. (Note: some people receive both Social Security and SSI benefits). The Social Security Act ties the annual COLA to the increase in the Consumer Price Index as determined by the Department of Labor’s Bureau of Labor Statistics. Some other adjustments that take effect in January of each year are based on the increase in average wages. Based on that increase, the maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase to $147,000 from $142,800. Social Security and SSI beneficiaries are normally notified by mail starting in early December about their new benefit amount. Most people who receive Social Security payments will be able to view their COLA notice online through their personal my Social Security account. People may create or access their my Social Security account online at Information about Medicare changes for 2022, when announced, will be available at For Social Security beneficiaries receiving Medicare, Social Security will not be able to compute their new benefit amount until after the Medicare premium amounts for 2022 are announced. Final 2022 benefit amounts will be communicated to beneficiaries in December through the mailed COLA notice and my Social Security's Message Center. The Social Security Act provides for how the COLA is calculated. To read more, please visit

I’m Covered

Because we care

Choose Mercy Care Advantage and say “I’m Covered!”

From physical and behavioral health to community esources and more Mercy Care Advantage (HMO SNP), a local, not-for-profit health plan, offering comprehensive health and prescription drug coverage, to individuals throughout Maricopa and Pinal counties, whose special needs and/or financial status make them eligible for both Medicare parts A & B as well as AHCCCS Medicaid. Members pay no monthly plan premiums for general wellness, behavioral, dental, vision and hearing care as well as coverage for unexpected health events that require emergency services, hospitalization, and more. Members also receive routine transportation for certain benefits, meal delivery following hospital discharge, home health care, and case management services.

Mercy Care Advantage provides integrated health coverage for:

Enroll today and say “I’m Covered!” Local: 602-414-7630 Toll-free: 1-866-571-5781 (TTY 711) Representatives are available 8am - 8pm - 7 days a week Learn more at

• Single individuals • Elderly individuals

• Persons with physical disabilities • Medicare cost-sharing members • Persons with developmental disabilities

Explore the Advantage

Mercy Care Advantage is an HMO SNP with a Medicare contract and a contract with the Arizona Medicaid Program. Enrollment in Mercy Care Advantage depends on contract renewal.



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Pima Council on Aging


PCOA CAREGIVER SUPPORT GROUPS – NOVEMBER Two are currently being held by Zoom plus seven in person.

To protect the confidentiality of the group sessions, access information will only be given to registered participants. Emails are sent out on Fridays with updated schedules and additional information. If you participated in the groups before COVID, and have not been receiving the emails, please check your junk or spam folder. Questions or to RSVP : call Sam in Caregiver Support at 520-305-3405 Participation in the groups can be in person (7 groups), by telephone or by computer/tablet/smartphone w/ video. 11/1, Monday , 1–2:30pm (East) IN PERSON 11/2, Tuesday , 12–1:30pm (Oro Valley) IN PERSON 11/4, Thursday , 1–2:30pm *Virtual ON ZOOM 11/8, Thursday , 1–2:30pm (Green Valley) IN PERSON 11/9, Tuesday, 5:30–7pm (Midtown) IN PERSON

Support groups are a way to connect with others who are walking the journey of caregiving like you are. You get to SEE (if you use the video option) that you are not alone. You get to hear other’s challenges and successes, learn about helpful resources, know that your story matters and that you have been heard. Support groups are facilitated by a professional and are a safe place for you to express your concerns, frustrations, etc. and learn that others feel this way too. In–person support group participants are required to wear masks and social distance. 11/15, Monday, 1–2:30pm (Midtown) IN PERSON 11/16, Tuesday , 9–10:30am * Virtual ON ZOOM 11/18, Thursday, 1:30–3pm (Midtown) IN PERSON

“A difficult time can be more readily endured if we retain the conviction that our existence holds a purpose, a cause to pursue, a person to love, a goal to achieve.” — John Maxwell *Event subject to change due to health precautions. See page 22 for details.


11/30, Tuesday , 9–10:30am (Southwest) Tucson Estates IN PERSON

To reserve a space or if you have any questions, please contact Sam at PCOA Caregiver Support,, (520) 305-3405

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Pima Council on Aging

Caregiving National Family Caregiver Month Celebration Self-Care is Not Selfish Events

Special thanks to all the volunteers in the Social Connections Network for helping with this event.


November 10th, Wednesday Family Caregiver Support Event Title : Self-Care gift bags and have lunch on us. At this drive through event, we will be handing out free goodie bags with activities, art/crafts, lunch cards, Partner program information and resources, useful tools and, of course, chocolate. You can choose from three restaurant locations for gift cards to buy you and your care recipient lunch on us! We will have three locations for your convenience. Maps provided upon registration When : From 11:30AM - 1 PM Where : PCOA Dusenberry Building 600 S. Country Club, Tucson AARP

November 5th, Friday Movie Showing Title : Alive Inside An “Exploration of music’s capacity to reawaken our souls and uncover the deepest parts of our humanity.” City Drive Films (won 7 audience film festival awards) Alive Inside Official Trailer 1 (2014) - Alzheimer's Documentary HD - Bing video watch?v=IaB5Egej0TQ When (two movie showings): 10 AM–12 PM or 1–3 PM Where : PCOA Dusenberry Building 600 S. Country Club Tucson, AZ PCOA Lupu Building 8467 E. Broadway Tucson, AZ Free in-person movie showing plus discussion afterwards. Social distancing maintained and masks required for safety.

November 10th, Wednesday Self-Care is Not Selfish Celebration of Family Caregivers Keynote talk : Social Connections: One of the Strongest Buffers to Caregiver Burnout. Plus Q & A Join us to hear G.J. Hodson talk about the strongest Buffer to Caregiver Burnout. G.J. Hodson is an empathetic and creative social scientist transforming family caregiving into a sociological specialty. Q & A will follow his talk. When : 10–11:15AM Where : PCOA Dusenberry Building 600 S. Country Club Tucson, AZ PCOA Lupu Building 8467 E. Broadway Tucson, AZ Free in person attendance of this live zoom talk will take place, along with zoom participation for those who will not be joining other family caregivers attending at a PCOA location for this offering. If joining by zoom, zoom link would be sent out after registration.

6700 N Oracle Rd, #331, Tucson PCOA Lupu Building 8467 E. Broadway, Tucson

Registration through Eventbrite : Or Register in person , by calling Donna DeLeon at 520-790-7573 ext. 1750 *Events are subject to change due to health precautions. See page 22 for details.

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Pima Council on Aging


Caregivers who provide substantial care are more likely to have physical & emotional health problems.¹

Nearly 15 million Americans provide unpaid care to an older adult.

National Health and Aging Trends Study, 2011 National Health and Aging Trends Study, 2011 ¹ Substantial care refers to involvement in health care activities, including care coordination and medication management. Take care of yourself. It is one of the most important things you can do as a caregiver.

Ask for help when you need it.

Join a support group— in person or online.

Spend time with friends.

Take breaks each day.

Keep up with hobbies.

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Pima Council on Aging

Caregiving attention on the present moment with kindness and curiosity and let difficult thoughts and emotions come and go without trying to change anything about the experience. Another group went through six weeks of guided sessions on progressive muscle relaxation, in which they learned to relax different groups of muscles in stages to make difficult emotions more tolerable. "The key difference between the two is mindfulness is just learning how to be with what is, without trying to change it, and bringing a compassionate, nonjudgmental stance to it," said Knowles, who is now a senior research fellow in the University of Washington School of Medicine and the VA Puget Sound Health Care System. "Progressive muscle relaxation is, 'How can we help you be in the present moment but make you feel better?'" A third group of study participants was assigned to a waitlist and did not receive either treatment. Those participants served as the study's control group – a benchmark to which to compare the progress made by the other groups. Learning Calculus While Running a Marathon Knowles, a certified mindfulness meditation

Grieving Spouses Should Focus on the Body Study Suggests

O'Connor has spent decades studying grief and its key components, including the craving for a lost loved one to return, which scholars refer to as yearning, and rumination – "the would've, could've, should've" of loss. "Because the would've, could've, should've have no real answers, you can just spin on those thoughts forever, so it can really get in the way of adapting," O'Connor said. These symptoms are stressful not only for the mind, she said, but the body, as well. Researchers have long known that bereavement and loss can lead to physical consequences, such as high blood pressure and even a higher risk of death. Finding suitable methods to address grief poses a unique challenge, O'Connor said, because learning those methods can add to stress. "We sometimes say grieving is like trying to learn calculus while running a marathon," she said. Using three questionnaires and a scale that O'Connor developed during her career of studying grief, the researchers measured whether grief severity, yearning and rumination improved in the mindfulness and relaxation groups compared to the waitlist group. They asked participants to read several statements – for example, "The feeling of wanting them back is so strong it is indescribable" – and indicate how often they feel that way on a five-point scale ranging from "never" to "always." Both the mindfulness and muscle relaxation resulted in clear improvements

By Kyle Mittan , University Communications, UA News

New research suggests that a simple relaxation technique is an effective coping strategy for grief after the loss of a loved one. Finding simple ways to relax the body might be effective in treating grief after the death of a loved one, according to new University of Arizona research. The unexpected finding comes from a new study that compared two methods for treating grief: one focused on the mind, the other on the body. The researchers looked at 95 widows and widowers who lost their spouses as recently as six months or within two years of the study beginning.

"What surprised us was that the ability to focus on the body and really relax the body turned out to be incredibly important in helping people

adjust," said Mary-Frances O'Connor, a UArizona associate professor of psychology and senior author of the study. The research was published August in the Journal of Consulting and Clinical Psychology by O'Connor and lead study author Lindsey Knowles, who did the work as a doctoral candidate in O'Connor's lab. One group of study participants was led through a six-week mindfulness training, in which they learned ways to focus their Mary-Frances O'Connor

facilitator, has long been interested in studying whether mindfulness could be used to address grief. She began working to answer that question when she arrived at O'Connor's lab in 2013.

Lindsey Knowles

(continued on page 21)

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Pima Council on Aging

Health, Aging & Wellness

Healthy Living with Ongoing Health Conditions , also named the Chronic Disease Self- Management Program (CDSMP), was developed for people with on-going health conditions - those who want to restore the feeling that they are living “with” a condition rather than letting “it” control them. Participants learn practical skills for managing their chronic health problems such as tools to communicate effectively with family, friends, and health professionals, problem solving and relaxation techniques which result in improved health status and proper utilization of the health care system. Participants receive a copy of the Living a Healthy Life with Chronic Conditions . The CDSMP 2-hour workshop meets once a week for six weeks. A Matter of Balance® is a program for people who have fallen in the past, have a risk of falling and/or may be reducing their activities due to a fear of falling. Participants learn to view falls, and the fear of falling, as controllable; set realistic goals to increase activity; change their environment to reduce fall risk factors; and exercise to increase strength and balance. The A Matter of Balance interactive workshop includes 8 two-hour sessions and are led by two trained facilitators for 12-15 participants. What is EnhanceFitness®? EnhanceFitness, a low-cost, evidence- based group exercise and falls prevention program, helps older adults at all levels of fitness become more active, energized, and empowered to sustain independent lives. You can recognize an EnhanceFitness class by the relaxed atmosphere and

The Healthy Living with Diabetes , also known as the Diabetes Self-Management Program (DSMP), is an interactive 6-week workshop, (2.5 hrs./wk.), for people with type 2 diabetes or pre-diabetes. Developed by Stanford University, it is designed to help individuals manage your diabetes symptoms by helping you learn skills to better manage your diabetes day to day. Some topics include: • Ways to deal with diabetes symptoms, fatigue, pain, hyper/hypoglycemia, stress, and emotional problems such as depression, anger, fear, and frustration. • Exercise for maintaining and improving strength and endurance. • Healthy eating. • Taking medications as prescribed. • Working more effectively with health care providers. Registered participants receive a copy of the book Living a Healthy Life with Chronic Conditions . Bingocize® is a health education program that incorporates exercise, nutrition, and falls prevention within the game of bingo. Groups of participants play Bingocize® twice per week, with each one-hour session consisting of exercises (range of motion, balance, muscle strengthening, and endurance exercises) and health education questions. The program is delivered using a traditional bingo game along with lay leader using a printed curriculum, materials, and prizes. All programs require pre-registration and have a contribution fee. They are all offered in-person and remotely. For program information, please contact our Healthy Living Department at (520) 305-3410.

the laughter in the room. A full hour of fun, EnhanceFitness focuses on dynamic cardiovascular exercise, strength training, balance, and flexibility — everything older adults need to maintain health and function as they age. Beyond cuff weights, EnhanceFitness classes do not require any special equipment. A certified instructor, who has completed the EnhanceFitness training, will safely lead the class through an hour of exercises at a pace that’s right for the participants. Over 99% of program participants say they would recommend EnhanceFitness to a friend. The class is proven to: • Improve physical function • Decrease depression • Protect against falls and fall injury • Provide a social benefit • Promote a physically active lifestyle The Healthy Living with Chronic Pain , also known as the Chronic Pain Self- Management Program (CPSMP), is a 6-week, two-hour workshop that helps participants, and their support person, deal with the ongoing issues associated with chronic pain. Participants receive a copy of the Living a Healthy Life with Chronic Pain book, and a CD, The Moving Easy Program. Workshop participants will learn about: • Strategies to overcome problems such as frustration, fatigue, isolation, and poor sleep • About exercises for maintaining and improving strength, flexibility, endurance and pacing activity with rest • Appropriate use of medications and evaluating new treatments • Communication skills • The importance of good nutrition in pain management

Learn Practical Skills • Gain Self-confidence • Manage Fall Risks • Positive Changes & Healthier Living

Page 14 | November 2021, Never Too Late

Pima Council on Aging

Health, Aging & Wellness

Healthy Holiday Foods and Fun

Make Smart Choices as You Celebrate the Season

about food.” “The key is not only what you eat, but how much you’re moving. Even little bits of extra exercise can be very helpful for everyone over the holidays.” Plan ahead for how you’ll add physical activity to days that might otherwise involve a lot of sitting. Get the whole family involved, Engel suggests. “You have to make an effort to incorporate exercise into days of big eating,” she says. “Otherwise the day will come and go.” Enjoy catching up with family or friends on a walk or jog instead of on the couch. In between meals, take a family hike at a nearby park, stroll around your neighborhood, or play a game of flag football. The emotions of winter celebrations come into this picture, too. “Joy, sadness, and stress are associated with overeating during the holidays,” Gluck says. “People who are emotional eaters may be particularly vulnerable to temptations around the holidays.” If holiday stress causes you to derail your healthy plans, consider ways to reduce stress and manage emotions. These might include talking to a trusted friend, meditation, physical activity, or just getting outside. Support your family and friends, too. Encourage them to eat healthy during celebrations and throughout the year. If you’re serving dinner, consider baking, broiling, or grilling food instead of frying. Replace sour cream with Greek yogurt, and mashed potatoes with mashed cauliflower. Make take-home containers available ahead of time, so guests don’t feel they have to eat everything in one sitting. Source: Adapted from NIH News in Health, National Institutes of Health, Nov. 2016

Eat what you love—in moderation,” suggests Jody Engel at NIH. Consider choosing items that are unique to the season, instead of eating foods you can have any time of the year. When you feel the urge to splurge in unhealthy ways, Engel recommends trying something else first, like drinking a glass of water, eating a piece of fruit, or climbing a few flights of stairs. You might even consider walking around your house or office for 5 minutes or more. You could also try eating mindfully, Engel suggests. Slow down to really taste and enjoy your food. Eating more slowly also allows your body time to signal your brain when you’re full, which takes about 20 minutes. If you eat too much too quickly, it’s easy to gobble up as much as twice what your body needs before your brain even gets the message. “Some people can eat less healthy foods in moderation and be fine, or have ‘cheat days’ where they allow themselves to eat whatever they want for a day and stay on track for the rest of the week,” Dr. Susanne Votruba says. “Others may have to avoid certain ‘trigger foods’ completely, or they’ll spiral into unhealthy eating patterns for the rest of the week or abandon their plan altogether. Everyone is different.” Because of these differences, Votruba says, it’s important not to force food on other people. “Even if you don’t have an issue with food, be aware of other people around you, and respect their choices,” she says. What if you do fall to temptation? “Every day is a new day when it comes to eating,” Votruba says. “If you overeat one day, work to get back on track the next meal or next day.” While food is a big part of the holidays, remember there are other paths to staying healthy. “Don’t make the holidays be just

Mashed potatoes and gravy, Grandma’s apple pie, and other holiday favorites can be a joyous part of any celebration. But to feel your best, you know you need to eat in moderation and stay active. How can you avoid temptation when delicious foods and calories abound? “From Halloween through New Year’s, there’s always a decision to make about food,” says Dr. Marci Gluck, an NIH psychologist. Tasty treats tend to appear more often at work and festive gatherings, and to come as gifts. They may also tempt you when grocery shopping. “As the holidays approach, it’s important to think ahead and make a plan,” Gluck says. Consider your health goals for the holiday season, whether it’s avoiding overeating, staying active, connecting with others, reducing stress, or preventing weight gain. You can plan to make time for buying healthy groceries, cooking at home, scheduling regular physical activity, and setting aside a little quiet time for yourself. “Most people just throw their plan out the window when they think they’ve slipped up, and they ‘fall off the wagon,’” Gluck says. “Celebrations don’t have to derail your lifestyle. You’ll have plenty of opportunities to follow your plan and eat healthy.” Look for opportunities to make healthy choices and feel good about them. “Small choices really can make big changes,” Gluck says. “Each moment that you put something in your mouth or choose to exercise adds up over time. That can be true for weight loss or weight gain.” Around the holidays, we often find ourselves with too many food options, for too many days in a row. It can be challenging to decide what to eat and when to say no.

November 2021, Never Too Late | Page 15

Pima Council on Aging

Health, Aging & Wellness

The PCOA Healthy Living Department is seeking community volunteers to train as peer leaders for an interactive chronic disease self-management program (CDSMP). The Chronic Disease Self-Management Program (CDSMP), developed by Stanford University, is a six-week program designed to help individuals with chronic conditions learn how to manage and improve their own health, while reducing health care costs. The program focuses on problems that are common to individuals suffering from any chronic condition, such as pain management, nutrition, exercise, medication use, emotions, and communicating with doctors. Program participants focus on building the skills they need to manage their conditions by sharing experiences and providing mutual support. It employs action planning, interactive learning, behavior modeling, problem-solving, decision-making, and social support for change. It is offered in two venues—online and through in-person, community- based settings such as senior centers, churches, community health clinics, and libraries. All training supplies, materials and ongoing support will be provided. Once trained, the peer leaders will work in pairs to facilitate workshops at various sites in Pima County. Each workshop runs for six weeks (one day a week for 2 ½ hours a day). Students, health professionals and members of the Pima County community are all encouraged to apply. Recruiting Volunteers! Interested in Helping People with a Chronic Condition Live a Healthier Life?

Looking for Volunteer Coaches! in g fo r Voluntee r Coaches !

A Matter of Balance Chances are you know someone who has fallen or who is afraid of A Matte r o f Balance Chances are you know someone who has fallen or who is afraid of falling. A Matter of Balance is a proven program designed to help people manage concerns about falls and increase physical activity. Union County Older Adult Falls Coaliti n is looking for volunteers to help provide this program. Free traini g provided. Coaches help participants become more confident about managing falls, help to identify ways to reduce falls, and lead exercises to help increase strength and balance. What do you need to be a coach? · good communication and interpersonal skills · enthusiasm, dependability and a willingness to lead small groups of older adults · ability to lead low to moderate level exercise. Fo r mor e informatio n cal l 937-642-2053 o r emai l rebecca . honaker @ uchd . net . falling. A Matter of Balance is a proven program designed to help people manage concerns about falls and increase physical activity. PCOA is looking for volunteers to help provide this program. Free training provided. Coaches help participants become more confident about managing falls, help to identify ways to reduce falls, and lead exercises to help increase strength and balance. What do you need to be a coach? • good communication and interpersonal skills • enthusiasm, dependability and a willingness to lead small groups of older adults • ability to lead low to moderate level exercise. A Matter of Balance: Managing Concerns About Falls Volunteer Lay Leader Model ©2006 This program is based on Fear of Falling: A Matter of Balance. Copyright ©1995 Trustees of Boston University. All rights reserved. Used and adapted by permission of Boston University. A Matter of Balance Lay Leader Model Recognized for Innovation and Quality in Healthcare and Aging, 2006, American Society on Aging. A Matter of Balance Lay Leader Model was developed by a grant from the Administration on Aging (#90AM2780). This work is funded either in whole or in part by a grant awarded by the Ohio Department of Health, Bureau of Healthy Ohio, Violence and Injury Prevention Program and as a sub-award of a grant issued by the Centers for Disease Control and Prevention (CDC), Preventive Health and Health Services Block Grant under the grant award number 3B01DP009042-13S1 and CFDA number 93.991. This program emphasizes practical strategies to manage falls. Classes are free and held twice a week for 4 weeks for 2 hours each. Participants learn to: • view falls as controllable • set goals for increasing activity • make changes to reduce fall risks at home • exercise to increase strength and balance This program emphasizes practical strategies to manage falls. Classes are free and held twice a week for 4 weeks for 2 hours each. Participants learn to: · view falls as controllable · set goals for increasing activity · make changes to reduce fall risks at home · exercis to increase strength nd balance

For more information and to register for an upcoming training, contact Mary O’Donoghue, mo’ , (520) 258-5062.

Page 16 | November 2021, Never Too Late

Pima Council on Aging

PCOA Puzzle

November Puzzle

59 Living on land and in water 64 Blowout 65 Of the nose 66 O T shipwright 67 Chart-toppers 68 Tors 69 Hilarity 70 Every family has one Down 1 Attics 2 Hilarious 3 Troublemakers, often 4 "Get Shorty" author --- Leonard 5 Place

6 Expression of relief 7 Property document 8 Hydrophobia 9 Enthusiastically 10 Name 11 Former name of Psiloritis, Cretan mountain

12 Can plating 13 Harley, often 19 Retirement arrangement

21 Legend 25 Itemize 26 A way to disappear 27 Watery swelling 28 Sly fighter? 30 Pear-shaped stringed instrument 31 Ice hockey player Bobby --- 32 Beatle married to Bach 34 Forego 35 Bill Cosby's late son 37 Candidate's aim 39 Merchandise 41 Agnus --- 44 Lymphatic tissues often removed after infection

34 Saturated 36 Injure 37 Methodology 38 Once again

Across 1 Feeble 5 Baghdad's --- City 9 Archie's wife 14 Spoken 15 U N nuclear watchdog 16 Reproduced sound 17 Thin coating 18 Theoretical birth of the Universe 20 In the offing 22 Desperate 23 Yarn 24 Before this 29 Business disappointment 33 Yorba ---, R M H's birthplace

Answers: following page 46 "Taken" star --- Neeson 49 Strait west of Wales, AK 50 Slender 52 Stocky horse 54 "Lorenzo's Oil" actor Nick --- 55 Rub out 57 Implement 58 Arthur --- stadium, Queens, N Y C 59 Military nurses' group (Abbr.) 60 Besmirch 61 Pro bono TV ad 62 Crone 63 The Emirates

40 Exchange 42 Sepulcher 43 Congenital 45 Genuine 47 Chinese ultimate reality

48 Not entirely natural, if born in this 49 Beaten by the Continental Army 51 Gist 53 Flared dress type 56 Class 58 Mendelssohn's "Scottish Symphony" key

November 2021, Never Too Late | Page 17

Pima Council on Aging

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