Living 50 Plus - December 2019






Do You Know What’s in Your Dietery Supplement? (StatePoint) Dietary supplements help people get the nutrients they need to thrive, and 77 percent of Amer- icans take them, according to the Council for Respon- sible Nutrition (CRN). However, experts say that in or- der to make smart choices down the line, it is necessary to understand changes being made to product labels. cisions, and being label wise, according to Wommack, means being committed to reading product labels, having knowledge of what information is featured and why, and making smart, well-informed purchasing de- cisions. International Units (IU), to the more common mea- sures of milligrams (mg) and micrograms (mcg). • Folic acid, an important nutrient before and during pregnancy, will be listed as folate and measured in mi- crograms of dietary folate equivalents (DFEs).

“While some of the changes to the label are more ob- vious than others, all of them are important to under- stand,” says Wommack. To help you understand the transition, CRN has iden- tified some of the noticeable aspects of the new Supple- ment Facts label: • New Daily Values (DVs) will reflect the latest nutri- tion science and changes in American diets.

“The Food and Drug Administration has mandated that all dietary supplement products feature updated labeling by January 2021 to reflect the evolution of the American diet, as well as advancements in nutrition science,” says BrianWommack, senior vice president of communications at CRN. “Larger manufacturers will comply by January 2020, and many other manufactur- ers will be introducing the new labels early, so it’s smart for everyone to get familiar with the updates now.” Eighty-two percent of Americans agree that the infor- mation on the label helps them make purchasing de-

• If sugar is added to the product, you will see the amount and percent DV.

To learn more about the coming changes, as well as for more tips and advice on reading supplement labels, visit or follow the conversation at #labelwise. “We all have unique nutritional needs. So, talk with your healthcare practitioner to understand how these label changes might impact you,” says Wommack.

• Vitamins A, D, and E will change from amounts in





5 Important Things Learned About Alzheimer’s Disease in 2019

increase dementia risk. Most older adults experience some form of vision and/or hearing loss later in life. New research suggests these sensory impair- ments may increase risk for cognitive decline and Alzhei- mer’s, especially if you experi- ence both. Sensory impairment screening may help identify older adults at higher risk of de- veloping dementia, thereby en- couraging early detection. This new knowledge opens the pos- sibility that preventing or cor- recting sensory impairments may reduce dementia risk. 5. Researchers are looking at new drug targets. Researchers are taking a fresh look at the possible causes for dementia and how drugs might be used to stop the disease in its tracks. More than 500 new candidate drug targets have been iden- tified that address everything from reducing inflammation in the brain to protecting nerve cell health. The Alzheimer’s Association’s Part the Cloud awards help fund this type of out-of-the-box research and move findings from the labora- tory, through trials, into possi- ble therapies for people. Researchers are poised to un- cover even more in 2020 and beyond. Increased funding for research from the federal gov- ernment and nonprofit orga- nizations is driving the rapidly growing body of knowledge about Alzheimer’s disease and dementia.

(StatePoint) In 2019, research- ers discovered meaningful insights into the causes, risk factors and treatment of Alz- heimer’s disease and other de- mentias. Here are five of their important discoveries: 1. Lifestyle may play a major role in reducing risk. We’re told that eating a healthy diet and exercising are good for overall health, but did you know that these habits may also reduce one’s risk for cognitive decline and dementia? Research re- ported at this year’s Alzheimer’s Association International Con- ference suggested that making

multiple healthy lifestyle choic- es -- including eating a low-fat, high vegetable diet, not smok- ing, getting regular exercise and engaging in cognitive stimula- tion -- may decrease dementia risk and may even offset in- creased risk caused by genes or exposure to air pollution. This year, researchers also learned that intensive high blood pres- sure treatment can significantly reduce the occurrence of mild cognitive impairment, which often leads to dementia. 2. A blood test is on the hori- zon. Researchers are working at full speed to develop a simple

blood test that can detect signs of Alzheimer’s early and accu- rately. Blood tests are cheaper, easier to administer, less inva- sive and more accessible than many advanced technologies currently available for Alzhei- mer’s research and diagnosis. Once these tests become avail- able in doctors’ offices, they may also play a role in early detection of dementia, giving individuals and families more time to plan for the future and get needed care and support services, and potentially in- crease their chances of partici- pating in clinical trials.

3. Alzheimer’s is different in men and women. Two-thirds of people living with Alzhei- mer’s disease in the U.S. are women, but scientists aren’t exactly sure why. This year, re- searchers learned about a num- ber of differences in progres- sion and risk between women and men, including newly iden- tified sex-specific risk genes, sex-based differences in how Alzheimer’s may spread in the brain and cognitive benefits for women who participate in the paid workforce.

4. Vision and hearing loss may




How Simple Steps May Prevent Type 2 Diabetes

and take action accord- ingly during November, which is Diabetes Aware- ness Month. “Preventing type 2 diabe- tes starts with ensuring that people are aware of their risks for developing the disease and advising them on interventions,” says Dr. Patrice A. Har- ris, M.D., M.A., president of the AMA. “Research shows that people who are aware of their condition are more likely to make the necessary long-term lifestyle changes that can help prevent or delay the onset of type 2 diabetes. The AMA is focused on

improving the health of the nation by leading the charge to prevent chronic disease. As the corner- stone of that effort, we are committed to helping America achieve no new preventable cases of type 2 diabetes.” A one-minute self-screen- ing risk test available at can help you determine where you stand. The AMA encourages those with high scores who learn they may be at risk for prediabetes to consult their doctor to confirm a diagnosis, as well as to find out how lifestyle

changes, such as losing weight, eating a well-bal- anced diet that includes a variety of foods and being more physically active can help prevent type 2 diabetes. For additional resources, visit amapre- and cdc. gov. The prevalence of adults diagnosed with diabetes more than doubled in the past 20 years, making it more important than ever that Americans find out whether they have predi- abetes. Armed with that knowledge, they can take steps to manage or even reverse the condition.

(StatePoint) More than one in three Americans -- over 84 million people -- have prediabetes, which is a serious condition that often leads to type 2 diabetes and other sig- nificant health problems, such as heart disease and

stroke. Despite its prev- alence, nearly 90 percent of people with the condi- tion don’t know they have it. The good news is that prediabetes can often be reversed. The first step is learning your risk, say ex- perts.

As part of its efforts to lead the charge in pre- venting chronic diseases and confronting public health crises, the Ameri- can Medical Association (AMA) is encouraging all Americans to learn their risk for type 2 diabetes




4 Ideas for Becoming a Lifelong Learner

(StatePoint) Lifelong learners know that it’s never too late to broaden one’s per- sonal and professional skills. Here are four cool ideas for doing so: • Learn to Dance: Dance is a beautiful art form offering opportunities to im- merse yourself in different cultures and musical genres. There’s also evidence that taking up dance can boost mental and physical health, reduce stress and improve memory. From ballet to ball- room to salsa to swing, there’s a dance style for everyone. So, consider taking that first step of learning the steps. • Play Piano: Playing the piano helps develop motor skills and improves cog- nitive learning. Now, thanks to new tools, you can develop your musical skills faster. Using the Casio Tone LK- S250 keyboard’s Key Lighting System,

have designs on writing the next great American novel to benefit from tight- ening your prose. A writing course can help anyone become more powerful, ef- fective communicator. • Get Mathematical: Whether you’re a student in school or a student of life, you can delve into math and improve your comprehension of related concepts us- ing, a web-based calculator which serves as a one-stop shop for en- hancing analytical thinking, and making math come alive for people of all ages. Usable on a desktop or tablet, the pro- gram also makes it easier for students and teachers to collaborate. Whether your goal is to succeed profes- sionally or boost your personal skills, you can pave the way by becoming a lifelong learner.

• Take a Writing Course: From email correspondence to meeting agendas to thank you notes, you are likely doing at least a little writing in your daily life. But is your message clear? You don’t need to

which features a voice-guided step-up lesson system, you can quickly learn its 60 built-in songs and sound great in no time.




SENIOR LIVING | HEALTH Non-Surgical Heart Valve Gives Patients New Lease on Life

my life.”

Dr. Christopher Meduri of Piedmont Hospital in Atlan- ta recommended that Brady undergo TAVR with the Boston Scientific LOTUS Edge Aortic Valve System. This next-generation TAVR technology was recently approved by the U.S. Food and Drug Administration for patients with severe aortic stenosis who are at high risk for open heart surgery. “Complete control over the procedure and confidence in the final result are incredibly important. We’ve had very good results with this new technology and it offers a minimally invasive, patient-centered treatment for those with aortic stenosis wanting to get back to their life as quickly as possible,” says Dr. Meduri. Thanks to the valve’s design that makes it uniquely re- positionable during TAVR, physicians can precisely place the new valve into an optimal position within the heart to restore proper valve function. And because not everyone’s aortic valve is the same size, the device is de- signed to conform to the patient, which minimizes any leakage of blood around the outside of the valve that could lead to future complications. “I feel like I have a new lease on life,” says Brady, now 90. “With my heart in good health, I have so much en- ergy to do the things I’ve always loved, like golfing and spending time outdoors with my wife. I’m so grateful for the peace of mind this procedure has given me.” For more information about severe aortic stenosis, TAVR and the LOTUS Edge valve, visit TreatTheHeart. com. If you think you may be experiencing symptoms of aor- tic valve disease, talk to your doctor right away.

(StatePoint) When walking up the stairs and playing golf started to become difficult even on a good day, re- tired Navy Captain Allen Brady attributed the change to aging. Having spent six years as a prisoner of war, Brady was no stranger to living with a challenge. But, when he couldn’t finish a round of golf without feel- ing fatigued and short of breath, he and his wife knew something was wrong and decided to visit a cardiolo- gist. Brady was diagnosed with a severe form of aortic stenosis, the most common valvular heart disease af- fecting an estimated 1.5 million Americans. Brady is among the 7 percent of people over the age of 65 affected by this condition. Aortic stenosis is char- acterized by significant narrowing of the aortic valve opening, which restricts blood flow and is often accom- panied by symptoms such as shortness of breath, chest pain, pressure or tightness, fatigue, feeling lightheaded

or dizzy, and difficulty when exercising or completing day-to-day activities. If left untreated, it can eventually lead to heart failure, severe infection and even sudden death. While historically, the only treatment option available to patients involved valve replacement via open-heart surgery, a less invasive procedure called transcatheter aortic valve replacement (TAVR) has become a more mainstream solution for those who are too sick to un- dergo traditional surgery. Patients who have a TAVR procedure typically experience a faster recovery time and less discomfort. “At 89 years old, I was very concerned about any kind of heart surgery,” Brady explained “But my doctor re- assured me that my age would not be a problem, and I knew I had to take action if I wanted to get back to





been in business in Minnesota, Wisconsin, and North Dakota for the last 40 years, will remain in the state. It has expanded now to Kansas and will be offering Medicare Supplements in Eastern Nebraska. It has 2 networks of providers in the state dependent on your zip code. I'm hearing that their rates may be decreasing for the year. Bright Health, the new carrier, locat- ed in Minneapolis, MN, was found- ed in 2016 and currently does busi- ness in Alabama, Colorado, Arizona, New York, Ohio, and Tennessee. It's expanding to Nebraska, Illinois, Florida, Georgia, and South Carolina for 2020. Their provider network is Midlands Choice so almost all Nebraska physicians are included in the net- work. They do provide pediatric dental and vision for kids under 19 in their plans. According to their brochure, they do offer a few perks in the program such as up to 4 rides to the doctor, meals after a hospital stay as well as cash for healthy behavior. If you are currently receiving subsi- dies through the Marketplace, your income needs to be updated to recalculate tax credits for the 2020 plan year. At that time, you'll be able to see plans and rates for both Medica and Bright Health. Federal subsidies are dependent on household size and annual incomes. For a household size of 1, if your income is between

$12,490 and $49,960 (100%-400% of federal poverty level), you could be eligible for a subsidy or assis- tance in paying for your premiums. For a couple, the income levels are $16,910 to $67,640 and a family of 4 is $25,750 to $103,000. Any incomes below the 100% of federal poverty levels are outside the range of subsidy and would have been eli- gible for Medicaid but Nebraska hasn't expanded their Medicaid consequently, they would have to purchase without assistance. Those clients wanting plans with Health Savings Accounts (HSA's) can contribute up to $3550 for an individual or $7100 for a family, those age 55 and older can add an extra $1000 for a catch-up contribu- tion in 2020. If you're a small business owner, you may want to think about moving to group health insurance. Here's the criteria for offering group insurance, you must have at least 1-W2 employee plus the owner. United Healthcare will offer insur- ance to the employee plus the owner. Blue Cross requires 2-W2 employees. Rates are lower for group coverage so you might want to consider it if you have a couple ranch hands, or have a small office staff, or small business with an employee. You are required to pay at least 50% of the employee por- tion of their premium but that is con- sidered a business expense and reduces your taxable income so it's not a dollar for dollar cost to your business.

For those looking for cost savings, Short Term coverage is available, several carriers are offering it for 2020. These are not ACA compli- ant as it doesn't cover pre-existing conditions and asks some health questions but it is available at a dra- matically lower price for those that don't receive subsidies. Both United Healthcare and the new player, Blue Cross Blue Shield are offering these plans. Blue Cross covers generic medications, doctor visits, and has 12 months of cover- age. It also covers preventative health services and outpatient men- tal health services. It's called Armor Health and those that are losing their Blue Cross grandfathered plans are being offered this in place of their coverage that is ending at the end of the year. That plan does- n't automatically roll over for those losing coverage, you do have to apply for it. Remember, these changes are for those people age 64 and under who purchase their individual health insurance and has nothing to do with Medicare. As you can see, there are lots of changes for 2020. Remember the Open Enrollment period runs from November 1 to December 15, so don't wait until the last minute to try to schedule an appointment. If you have questions or want to schedule an appointment with Rebecca, call Phares Financial Services at 308-532-3180.

By Rebecca Nordquist, RD, MHA, CLTC

Oh my, the changes are daily. Let's try to keep up.

As you may be aware, Open Enrollment for Individual Health Insurance (NOT Medicare) begins shortly. It seems like we just did this, but it begins November 1st and continues to December 15, 2019 for a January 1st effective date. There have been significant changes in the Nebraska market for 2020. We'll have a new player in the Nebraska health insurance market. Bright Health is entering the ACA compliant market in addi- tion to Medica for next year. Those with grandfathered Blue Cross plans will terminate at the end of December this year.

Medica, although a new carrier to Nebraska and Iowa in 2016, has


D8 DECEMBER 2019 THE NORTH PLATTE TELEGRAPH Living with Chronic Liver Disease? Be Aware of Hepatic Encephalopathy LIVING 50 PLUS

(StatePoint) Approximately 30 million people in the U.S. have some form of liver disease, which occurs in people for many different reasons. Some common types and causes of liver disease include hepatitis, caused by viruses A, B, and C, nonalcoholic fatty liver disease (NAFLD), which is caused by too much fat in the liver cells, and alcohol-related liver disease, caused by con- suming too much alcohol. Having liver disease over a long period of time can result in cirrhosis, an advanced chronic liver disease, which then puts a patient at risk for hepatic encephalopathy (HE) – a serious complica- tion of advanced liver disease. “Up to 80 percent of patients with cirrhosis can devel- op HE. This condition can have very debilitating effects on patients and takes a toll on caregivers, especially as the condition progresses,” says Dr. Howard Franklin, vice president of Medical Affairs and Strategy at Salix Pharmaceuticals. “However, many patients with liver disease, especially younger patients, are not even aware they are at risk for developing HE, so early recognition of signs and symptoms is critical.”

A Closer Look at HE In patients with advanced chronic liver disease, the liv- er is damaged so it cannot filter toxins out of the blood the way a healthy liver would. These toxins can then build up and travel through the body until they reach the brain. The buildup of these toxins in the brain can then lead to the symptoms of HE. Onset of HE can start slowly, and at first, people with the condition may not even be aware they have it. Fam- ily or friends may often be the first to notice someone with HE is acting differently. Symptoms of HE, which can encompass both mental and physical symptoms, may vary for each person and include: • Mental symptoms - Forgetfulness, confusion, poor judgement, not knowing where you are or where you are going or personality changes • Physical symptoms - Changes in sleep pattern, trem- ors or shaking of hands or arms, slowed or sluggish movement, slurred speech and changes in breath odor

In the most severe form of HE, people can become un- conscious and enter a coma. These symptoms can have a significant impact on daily life, such as not being able to drive a car, not being able to work and not being able to care for oneself and hav- ing to rely on a caregiver. Proper and early treatment and management of HE can help slow its progression before it gets worse. Treatment Options Talk to your doctor to learn more about HE and how to manage this condition. Lifestyle changes, such as changes in diet or eliminating certain medications, may also help. “Once diagnosed and put on treatment, proper adher- ence to medication is critical,” says Dr. Franklin. If you or someone you know has chronic liver disease and begins to experience any symptoms of HE, it’s im- portant to talk to your doctor right away. This is the first step toward helping find an appropriate treatment plan to manage the condition.

How to Navigate the Challenges of Caregiving

place for finding care and support.

greater comfort and control. These updates are partic- ularly critical, as sensitive and thinning skin is preva- lent among older adults and is a common side effect of many medications. To learn more, visit TREO. As more companies introduce tools designed for care- givers, such personal care tasks as shaving have the po- tential to become easier, safer and more comfortable.

(StatePoint) As the population of older U.S. adults grows, more Americans are taking on long-term care- giving duties for loved ones. An estimated 43.5 million adults in the U.S. have provided unpaid care in the past 12 months, according to AARP. “While caregiving presents many opportunities for growing strong bonds with loved ones, the work itself can be demanding, eventually taking a toll on those shouldering the burden,” says Lakelyn Hogan, a geron- tologist and caregiver advocate at Home Instead Senior Care. Hogan and the experts at Home Instead Senior Care are sharing tips to navigate the challenges.

Search for Innovative Tools

Innovative companies are taking note of the needs of caregivers and are designing everyday products to help them make daily tasks easier and more comfortable for all involved. In the realm of personal care, this trend is especially important: personal care activities were iden- tified in an AARP survey as among the most challeng- ing daily activities caregivers must manage. When it comes to shaving, a task that seems simple enough when performed on oneself, things can get tricky. Currently, 46 percent of caregivers are using a disposable razor to provide an assisted shave to their loved one at home, according to a Gillette survey. The problem? When caregivers use one of the 4,000 razors designed for shaving oneself, turning it around to use on someone else is trickier than you might expect -- not to mention time-consuming. Fortunately, there is now a razor specifically engineered for assisted shaving. A first of its kind, the Gillette TREO razor includes spe- cial features that protect against nicks and cuts, and its clog-free design doesn’t require the use of water. What’s more, the razor has an ergonomic handle providing

Make Space for Yourself

Prioritizing your own health and happiness is critical. After all, if your health suffers, it could make it impos- sible for you to continue caregiving. Rely on family and friends or a part-time professional to step in and give you a chance to recharge. Use the personal time to read, journal, exercise, take a nature walk, visit your doctor or simply meet with friends. You may also benefit from joining a caregivers’ support group. Luckily, social me- dia has made it simple for people to find one another and connect. While the roles and responsibilities of caregiving vary, leveraging the resources designed to universally assist caregivers can help you navigate the many challenges of daily life.

Use Online Resources

To fully advocate for your loved one, it’s necessary to understand his or her medical conditions and the spe- cific areas where extra help is needed. Doing so will help you secure support services, get information from doctors, ensure medications are being administered safely and even help you make appropriate meal and transportation arrangements. Most reputable sources of condition-specific information can also double as a

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