1012 RM Senior Health Guide

s e n i o r health guide

Help and Hope for alzheimer’s diseasepage 4

affordable Care act 101Page 6

Senior nutritionPage 10

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Mary Daniels still thinks of her sister everyday, even though her sister died of Alzheimer’s

disease more than two years ago. She recalls their family road trips

squished in the back of dad’s sturdy Ford, their plaid school uniforms and how they never quite covered their knobby knees, and their greatest adventure of all—mov-ing from the Midwest to Colorado where they become school teachers.

But she also remembers not too long ago when her younger sister told her, through tears, that she felt some-thing was wrong with her.

“She even said that she thought she had dementia,” Daniels says. “I gave her a hug and we talked a little bit. But looking back and knowing what we do now, and what I know about the disease, I could have done more. I wish I would have.”

That was in the early ‘90s, two decades ago. It was before Alzheimer’s disease would be defined as one of the most prevalent and feared illnesses around the world. It was also before the fact that every 68 seconds someone is newly diagnosed, and before the Obama administration would pledge to commit $100 million to increase awareness and to finally find a cure.

For Daniels, her sister’s diagnosis was before she knew what resources, support and expert guidance would be available.

“I could have helped her plan for the rest of her life, “ Daniels says. “I think I could have made it easier than it was.”

Early diagnosisAnd that is the cause that Emmalie Conner, the Northern Colorado Re-gional Director of the Alzheimer’s As-sociation, champions everyday.

“Admittedly, many people don’t want to find out if they have Alzheim-er’s disease, because they believe that there is nothing that can be done,” Con-ner says. “But that isn’t true. An early diagnosis can open the door for a jour-

ney where the best options—medical, social and financial—can be considered and put in place. And that can make a huge difference when it comes to quality-of-life issues.”

It has for Janet Neubauer, who lives in Berthoud. After her boss pointed out mistakes she was making at work, she went for a medical consultation and found out she had Alzheimer’s disease.

“Finding out early is important,” Neubauer says. “It means getting a jump start on the medications that do help slow down the progression of the disease. Having the extra time with fewer memory problems has given me the time to enjoy things that mean a lot while I still can.”

support groups The diagnosis also opened the door to access support groups offered through the association. Together with her hus-band, they quickly joined the conversa-tion and share life strategies with others.

“The support group is probably

what helps me cope the most day to day,” she says.

Often those support groups are what provide solutions and ideas for others who are also facing similar challenges.

Throughout the different stages of disease, the Alzheimer’s Association provides support groups for caregivers as well as social programs.

“We are here to provide and en-hance care for all those who are affected by the disease,” says Conner.

For Neubauer, an early diagnosis has given her a renewed commitment to her philosophy: Slow down in life and smell the roses while you can.

“Undoubtedly, a diagnosis of Alzheimer’s disease can be frighten-ing,” Conner says. “But there is sup-port and knowledge out there that can definitely make it easier for individuals and families.”

Julie Piotraschke is the media liaison for the Alzheimer’s Association, Northern Colorado Region

Help and hope for Alzheimer’s DiseaseAn early diagnosis allows you to take advantage of services and treatments and make accommodations

J u l i e P i o t r a s c h k e

Ten warning signs of Alzheimer’s Disease Memory loss that disrupts daily life

Challenges in planning or solving problems

Difficulty completing familiar tasks at home, at work or at leisure

Confusion with time or place

Trouble understanding visual images and spatial relationships

New problems with words in speaking or writing

Misplacing things and losing the ability to retrace steps

Decreased or poor judgment

Withdrawal from work or social activities

Changes in mood and personality

Get help:The Alzheimer’s Association: (800) 272-3900, www.alz.org.


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One of the most hotly debated is-sues in the current political climate is the Patient Protection and

Affordable Care Act (ACA). Everywhere people gather, the primary question seems to be the same: What does it all mean?

Written by Congress at the urging of President Obama, the Act was passed in March 2010. The bill was met with both excitement and dissonance, and it created a partisan battleground.

One of the significant challenges the bill met was whether or not it was legal to charge Americans a fine if they failed to comply with the mandate of purchasing health insurance. The U.S. Supreme Court deliberated on this as-pect of the bill’s legitimacy during the beginning of 2012 and in June 2012 found it to be constitutional.

There also has been a sizable discus-sion as to the bill’s feasibility especially given our nation’s financial and eco-nomic issues. The concerns regarding the cost and spending of the Act are hard to comprehend without actually reading the entirety of the bill – all 2,400+ pages of it—and the numerous reports on how spending will occur under the bill. Critics contend the Act will increase the federal deficit. Many assert the bill will add billions or maybe even trillions of dollars to the deficit, and/or irreparably damage the very core of Medicare and Medicaid. Proponents of the Act claim it will be financed by money already in the system and that it won’t cut services to patients, but rather expand them.

A recent study by the Institute of Medicine shows roughly $750 billion in waste in the health-care industry, much of which is related to overpay-ment for procedures, too many non-essential procedures performed and non-communication between provid-ers leading to duplication of tests and services. In a recent article for The Washington Post, correspondent Sarah Kliff neatly outlines the waste spend-

ing in health care, especially health care related to the elderly.

“There’s a lot of space for waste. Not enough preventive care happens, meaning that costly com-plications may develop. Self-management is a challenge, with seniors literally taking dozens of prescrip-tions. A lack of coordina-tion between doctors compounds problems later down the line.”

The expan-sion of services through and poli-cies of Medicare due to the ACA attempt to address these issues.

Winds of changEAs with any large scale regulatory makeover, the Affordable Care Act was designed to be implemented over a period of time, rather than all-at-once, to ease the burden of transition-ing to new practices and procedures. Components of the bill were designed to be phased in over a four-year peri-od, which began as soon as the bill was signed into law. Seniors on Medicare have undoubtedly noticed some of the changes already; the most predomi-nant aspects of Medicare reform oc-curred throughout 2011, namely clos-ing the prescription “donut hole.”

While there have been great strides made in recent years to increase the availability of generic replacements of medications, in many cases this coverage is not enough when name brand drugs are the only option.

Pre-Affordable Care Act, this problem has been coined the “donut hole,” a literal

gap in prescription coverage for a signifi-cant portion of Medicare users. The ACA has several strategies for closing the “donut hole.” In 2010, Medicare users within the

“donut hole” received a one-time, tax-free, rebate of $250 to

augment spending on medication within

the coverage gap. In 2011, discounts for prescription drugs were extended to Medicare Part D patients. There now is an automatic 50-

percent discount on covered name-

brand prescriptions for those on Medicare

who fall into the cov-erage gap. There also is a

seven-percent discount for generic medications under the same criteria. This is one of the farthest-reaching components of the ACA as it is intended to continue add-ing discounts on prescription medications annually through 2020.

In 2014, Medicare recipients who also qualify for Medicaid will notice changes. People who previously weren’t eligible for coverage will get benefits related to their income. Both programs, Medicare and Medicaid, will expand as ACA phases in millions of new patients. By the end of that year, the law is in-tended to put individuals, families, small businesses and the whole of the Ameri-can public in charge of their own health.

One of the more innovative fea-tures of the law is that of the “Patient’s Bill of Rights.” The Bill provides 12 amendments outlining rights and pro-tections for health-care consumers, and provides the incentive and encourage-ment for individual’s to advocate for their own health.

Specifically related to seniors, are

Affordable Care Act 101Patient Bill of Rights, low-cost screenings, closing the donut hole, and more...

B y k y l e M o y e r


four amendments that bolster their rights: • Coverage for Americans with preexisting conditions• No lifetime limits on coverage• Removal of barriers in accessing emergency services outside of coverage

networks• A guaranteed right to appeal for coverage. Each amplifies seniors’ voices in

their own health care.Additionally, the bill provides many specific services for

seniors on Medicare, most notably preventive services, which fill important roles in health and well-being. Annual wellness exams are integral to the program because they provide doctors and physicians the time and space to screen for possible health problems. The annual exam is free of charge and subsequent related visits will only require a small co-pay. And there are a number of no- or low-cost screenings that will be available. The screenings cover a wider variety of health risks to Ameri-cans over 65 and include:

• Bone mass measurement• Cholesterol and cardiovascular screenings• Diabetes screenings• Flu, pneumonia, hepatitis B shots• Mammograms• Prostate cancer screening• Nutrition education and management for diabetes or kidney disease

Another addition to the services for seniors under the Af-fordable Care Act is that of the “Community Care Transitions Programs.” The bill’s authors recognized one of the biggest health risks to seniors is post-hospital care. Making this kind of care part of a streamlined program, which will be available to all those on Medicare if programs are in place in their area on a state-by-state basis, the “Transitions” program is designed to increase communication between medical professionals fol-lowing hospitalizations to “avoid unnecessary readmissions.” Health-care pundits seem to agree that this is a reasonable en-hancement to the Medicare system that will undoubtedly help seniors safely rehabilitate following hospital stays.

MorE bEnEfits for sEniors The ACA contains three more provisions directly aimed at improving the quality of health and life of our nation’s elderly. The first is the Community First Choice option, which is a system designed to provide home-based care as an alternative to nursing-home care. The second is the Elder Justice Act, which recognizes and responds to the significant problem of elder abuse in places of live-in care. Through the use of forensics judicial investigation of wrongdoing by care providers, as well as extended education for nursing staff, the Act provides a strong ally for seniors in nursing homes. The final addition is the expansion of home-based care provided by medical professionals. This third component is an exten-sion of preventive care emphasis of ACA, which stresses the importance of communication and treatment to keep seniors out of the hospital.

For more information about the ACA, visit www.health-care.gov and www.medicare.gov.

Kyle Moyer is a freelance writer based out of Fort Collins.


Glaucoma is a leading cause of blindness in the world. It is a disease that results in a de-generation of the optic nerve, the nerve that carries visual information from the eye to the brain. As the optic nerve degenerates, vision loss oc-curs, usually beginning in the peripheral vision and moving centrally. Visual field tests are used to monitor the amount and rate of vision loss. Optic nerve scanners and photographs are used to monitor change in the structure of the optic nerve. Most commonly, glaucoma is caused by an elevated eye pres-sure. Glaucoma is diagnosed by your eye doctor by a complete eye exam. Once glaucoma is diagnosed, depending on the severity, glaucoma checks can be required up to four times a year. Treatment for glaucoma reduces eye pressure through the use of medications, laser, or surgery.

The medications used to treat glaucoma are most commonly given in the form of an eye drop. Drops are taken 1 to 4 times each day. Consistency is the key to maintaining a low, steady eye pressure to slow the progression of nerve damage. Medications work by decreasing the amount of fluid made in the eye, or by increasing the outflow capacity of fluid from the eye. There are 4 common classes of medica-tions and while some patients’

glaucoma is controlled with one drop, many require one from multiple classes or even one from each class.

Laser surgery is another op-tion for controlling glaucoma. Selective laser trabeculoplasty, or SLT, is a common treatment for glaucoma and can be used before medications if desired. The laser is applied to the fil-tering meshwork in the eye to help enhance the outflow of fluid and lower the intraocular pressure. The laser is effective in 70-80% of patients and while the effect varies for each indi-vidual, it is a relatively safe way to treat glaucoma. Medications and laser can be used together.

Surgery is another option for treating glaucoma. There are many different types, and there are many new, innovative sur-gical procedures currently in clinical trials. The most com-mon surgery for glaucoma involves a hole, or stent that creates a new drainage path-way out of the eye. Typically a lower pressure can be achieved with surgery than with drops.

As with all surgery, there are risks which include bleeding, infection, a pressure that is too low, or a pressure that is too high. While many filtering surgeries last for years, some will slowly scar closed and need to be re-opened or repeated. Cataract surgery alone has been shown to lower the eye pres-sure in some people. In some cases, glaucoma surgery can be performed in conjunction with cataract surgery.

Glaucoma is a disease that can lead to blindness. With consistent testing and treat-ment, glaucoma damage can usually be slowed or stopped. As our understanding of glaucoma increases more people are preserving vision for their lifetime.

For additional information on Glaucoma and other vision threatening conditions, please visit us online at www.eyecenternoco.com

Glaucoma:What Do I Need to Know?

- P A I D A D V E R T I S E M E N T -

Kent Bashford, DOFellowship-Trained Glaucoma Specialist


Glaucoma is a leading cause of blindness in the world. It is a disease that results in a de-generation of the optic nerve, the nerve that carries visual information from the eye to the brain. As the optic nerve degenerates, vision loss oc-curs, usually beginning in the peripheral vision and moving centrally. Visual field tests are used to monitor the amount and rate of vision loss. Optic nerve scanners and photographs are used to monitor change in the structure of the optic nerve. Most commonly, glaucoma is caused by an elevated eye pres-sure. Glaucoma is diagnosed by your eye doctor by a complete eye exam. Once glaucoma is diagnosed, depending on the severity, glaucoma checks can be required up to four times a year. Treatment for glaucoma reduces eye pressure through the use of medications, laser, or surgery.

The medications used to treat glaucoma are most commonly given in the form of an eye drop. Drops are taken 1 to 4 times each day. Consistency is the key to maintaining a low, steady eye pressure to slow the progression of nerve damage. Medications work by decreasing the amount of fluid made in the eye, or by increasing the outflow capacity of fluid from the eye. There are 4 common classes of medica-tions and while some patients’

glaucoma is controlled with one drop, many require one from multiple classes or even one from each class.

Laser surgery is another op-tion for controlling glaucoma. Selective laser trabeculoplasty, or SLT, is a common treatment for glaucoma and can be used before medications if desired. The laser is applied to the fil-tering meshwork in the eye to help enhance the outflow of fluid and lower the intraocular pressure. The laser is effective in 70-80% of patients and while the effect varies for each indi-vidual, it is a relatively safe way to treat glaucoma. Medications and laser can be used together.

Surgery is another option for treating glaucoma. There are many different types, and there are many new, innovative sur-gical procedures currently in clinical trials. The most com-mon surgery for glaucoma involves a hole, or stent that creates a new drainage path-way out of the eye. Typically a lower pressure can be achieved with surgery than with drops.

As with all surgery, there are risks which include bleeding, infection, a pressure that is too low, or a pressure that is too high. While many filtering surgeries last for years, some will slowly scar closed and need to be re-opened or repeated. Cataract surgery alone has been shown to lower the eye pres-sure in some people. In some cases, glaucoma surgery can be performed in conjunction with cataract surgery.

Glaucoma is a disease that can lead to blindness. With consistent testing and treat-ment, glaucoma damage can usually be slowed or stopped. As our understanding of glaucoma increases more people are preserving vision for their lifetime.

For additional information on Glaucoma and other vision threatening conditions, please visit us online at www.eyecenternoco.com

Glaucoma:What Do I Need to Know?

- P A I D A D V E R T I S E M E N T -

Kent Bashford, DOFellowship-Trained Glaucoma Specialist

10 | RMSENIOR | HEALTH GUIDE

Eating properly has special chal-lenges in senior years. We strive to stay active and fit, yet our

physical activity tends to decrease. We need to get all of our vitamins, minerals, protein, fiber and fat—with fewer calo-ries. Our vitamin and mineral needs do not decrease with decreased activity.

How can we continue to enjoy rich desserts, fried foods, candy, sugary sodas, and alcoholic beverages?

First we must acknowledge that if we have reached senior status in good health, then we must be doing some-thing right! We don’t need make radical eating changes late in life, unless our survival depends on it.

If you suspect that you are not meeting your basic nutrient needs, your best bet is to simplify. Focus on getting enough calcium, fiber, and protein—and the necessary vitamins, minerals, and nutrients will probably follow. If you enjoy cereal, choose one that is fortified with 100 percent of essential vitamins and a significant amount of minerals and fiber. When you add milk to that cereal, you will get a serving of calcium, which is essential for bone health, ner-vous health and blood-pressure control.

Calcium is best obtained from food (and not pills); primarily milk, yogurt, cheese and canned fish with bones. Foods made from milk, such as pudding, custard and chowders, are equally good calcium sources.

Calcium-fortified beverages are available in most supermarkets; includ-ing orange juice and soy beverage.

Yogurt with live bacterial cultures has an added benefit of introducing good bacteria into the intestines, which provides a barrier to disease.

Dietary fiber is more than an an-tidote to constipation. Fiber fosters the growth of good bacteria in the intestines and defends against infection. One of the richest sources of fiber is the legume (pinto, navy, garbanzo, lentil, kidney, small red, cannellini, etc.).

The American diet tends to be rich in protein. Protein works best when con-sumed at each meal, starting with break-fast; as it helps to stabilize blood sugar, and is truly the body’s building block. The highest-quality proteins are found in animal products. Plant proteins also con-tribute to meet protein requirements.

Americans are now cautioned to reduce salt and sodium intake and we know that most sodium we consume comes from additives used in process-ing. Cooked lentils are virtually sodium free, but a canned lentil soup may have 500 mg of sodium per serving (1/4 of recommended daily intake).

Lightly salting your homemade soup recipe is not a problem. Only 5 percent of people’s salt intake comes from the saltshaker.

You should consume twice as much potassium as sodium. Consuming half of your meal or plate as vegetables will help you get plenty of potassium and this strat-egy will help to control blood pressure.

The healthy American plate looks like this: half full of vegetables; one-fourth full of protein rich foods—such

as fish, meat, poultry, eggs, cheese and legumes; and one-fourth with grains—such as bread, pasta, rice, barley, corn, kasha, and quinoa. (Legumes are unusual because they serve as a grain serving and a protein serving). The healthy mono- and polyunsaturated fats and oils— including olives, nuts, and seeds are added to the meal. A serving of fruit and a calcium-rich dairy product are found to the side of the plate at the meal. Are you now asking, where’s the red wine and dark chocolate? Remember to consume these healthy choices judiciously.

The nutrition challenge is to eat three or more meals a day as recommended, flavoring with herbs, using small doses of sugar and salt, and then to consider what, if anything, you are truly missing.

All foods can fit when enjoyed mod-erately and as part of a healthy lifestyle.

Lana L. Olsson is a registered dietitian, board certified in gerontological nutri-tion. Lana consults for The Hillcrest in Loveland, and is the dietitian for a V.A. home based primary care team based in Greeley, CO.

The senior nutrition challengeBalancing the essentials with a little room left for dark chocolate

l a n a l . o l s s o n

HEALTH GUIDE | RMSENIOR | 11

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1012 RM Senior Health Guide