Health care community residents practice gratitude through journaling

Research has shown that recognizing the good may improve well-being

By Tina L. Kies for Next Avenue

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Her pale blue eyes sparkle when she smiles. Peacefully observing all that surrounds her, she is a history book waiting to be opened. An experience outlines every wrinkle, silently alluding to the secrets, loss, love and happiness that she has experienced during her lifetime. A few weeks shy of her 90th birthday, she speaks of the celebration that her family is planning for her with the enthusiasm of a child.

“After all,” she says candidly, “I don’t know how many more of these I’ll get!”

If you ask her what her secret is, she’ll give you that million-dollar smile accompanied by one simple, but multifaceted word: gratitude.

This beautifully spirited woman goes by the name of Joy (ironically, or not) and she is one of about a dozen long-term residents at Shuksan Healthcare Center, a 52-bed short-term rehabilitation and skilled nursing facility in Bellingham, Wash. — a facility where gratitude is not only practiced regularly, it has been engrained into the philosophy of resident care. (I am the community relations director there.)

Encouraging a ‘lifestyle shift’ through journaling

Spurred by the optimism of residents like Miss Joy and research conducted by experts on gratitude, Shuksan staff members implemented a weekly gratitude journaling exercise in the fall of 2016 not only to emphasize the positives surrounding our residents’ lives, but alsoto  encourage a lifestyle shift.

The concept of gratitude journaling is not novel to Shuksan. Previous studies have demonstrated just how powerful the act of practicing gratitude can be for older adults, improving emotional and physical well-being. In an ongoing study conducted by Robert Ammons of UC Davis, the world’s leading expert on gratitude, it was found that older adults who kept weekly gratitude journals experienced fewer physical symptoms, exercised more, enjoyed a better outlook on life, were more likely to reach their goals and felt more connected.

From a skilled nursing perspective, the physical and emotional benefits were inspiring and, subsequently, prompted the implementation of this new resident activity. The process, now about six months in, has been enlightening and truly evolutionary for everyone involved, residents and staff alike.

Time for appreciation

For 30 minutes every Wednesday morning, our residents know that gratitude journaling is taking place in the main activity room. One by one, they take their seats around the table and open their journals, usually spending a few quality moments reading last week’s entries.

With smiles and nods of recollection, those who can write will write and those who need assistance will receive it. As pens meet paper, you can almost begin to see the sentiments of gratitude in the air. With optimistic hearts and disintegrating walls, our residents lose themselves in the exercise and begin to live in the world of gratitude.

For some, this mindful feeling may only last during the 30 designated minutes. For others, the sensation will carry with them throughout the remainder of the day, affecting everyone they encounter, including their own lovely reflections in the mirror.

I’m one of the lucky staff members who participates in the weekly gratitude journaling exercise with our residents. After first providing writing assistance to those in need, I begin my own reflection of gratitude. Once everyone has had a chance to write, they are given an opportunity to share. That’s when I find my heart swelling, the corners of my mouth lifting into a gentle smile, and when my own gratitude for the lovely individuals around me begins to overwhelm my soul.

A common force

During a recent gathering, the sun peeked out from behind the dark winter clouds. The blue sky filled our activity room with rays of sunlight and you could feel the mood shift. Almost immediately, residents began commenting on how happy they were to feel the warmth of the sun, how we live in one of the most beautiful places on earth, and how fortunate they felt for their friendships at Shuksan.

Magnetically, the gratitude for one another began to pull us closer together around the table. Bodies leaned in, heads tilted toward one another and hands extended to touch those of their neighbors.

“Isn’t she just lovely,” remarked a resident.

“I love how your smile brightens the room,” commented another.

“Oh, and look at his sweet smile,” the compliments continued.

And then, as if I had orchestrated the entire dialogue myself, I heard:

“I sure am grateful for you all!”

Gratitude in caregiving

From a caregiving perspective, practicing gratitude in the workplace opens our hearts to those we are serving. It’s our opportunity to create a trusting, connected and compassionate environment for our residents who would, let’s be honest, rather be home than here with us.

With that in mind, the onus is on us to apply the benefits of gratitude in such a way that encourages our residents to embrace the positives that do exist in their lives, rather than the negatives.

Our desires for the journaling sessions are being met; what started as a prompted weekly exercise has now transformed into a true lifestyle change.

‘Gratitude is the memory of the heart’

There is a French proverb from the pioneering deaf educator Jean Baptiste Massieu who said, “La reconnaissance est la memoire du coeur.” It means: “Gratitude is the memory of the heart.”

Living a life of gratitude allows our hearts to become full — full of life, love and peace.

Our long-term goal is to bring life to our residents in whichever way we can as caregivers. With the understanding that living a life of gratitude can have immense positive benefits for older adults, we hope that we’re opening a door for our residents to reap some of these benefits.

If anything, I can say with confidence that gratitude journaling has started this process for us at Shuksan Healthcare Center, and for the 30 minutes that we meet each week, life is being pumped into all of us.

© Twin Cities Public Television – 2017. All rights reserved.

Prepare for surgery with exercise and diet

‘Prehabilitation’ is slowly being recognized as valuable for success after a procedure

By Judith Graham for Next Avenue

Preparing-For-Surgery-web

Credit: Getty Images

A dozen years ago, at the age of 50, Lillie Shockney decided to have breast reconstruction surgery after two bouts of cancer and two mastectomies. The procedure called for removing a flap of skin and fat from her abdomen, used to rebuild her breasts.

Shockney knew a lot about breast cancer and the trials of recovery: she was (and still is) director of the breast center at Johns Hopkins’ Sidney Kimmel Cancer Center. Characteristically, this dynamic nurse didn’t want to stay in the hospital for any longer than absolutely necessary.


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What I learned from my gray hair experiment

Giving up my copper-red locks wasn’t easy, but it was time (or was it?)

By Wendy Schuman for Next Avenue

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Last spring, I decided it was time. I would no longer color my hair. I vowed that after my youngest child’s wedding in April, I was going to let it go silver. I’d had auburn hair since childhood and had been touching up the gray for about 15 years.

I used to be able to go five weeks between color appointments. But recently, the roots were showing within a week or two. On my next birthday I would turn 70, and it seemed wrong to fight nature.

After all, I wasn’t someone who would go for a facelift or even a smidge of Botox. I was a child of the ’60s, for God’s sake! And I would save so much money and time, especially when I added in the cost of highlights every few months.

I boldly announced my decision to everyone I knew, including my hairdresser, Michelle. “I think you’re making a mistake,” she said, shaking her head sadly. But she had skin in the game.


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10 ways to keep your old dog healthy and happy

Some of these potential solutions are easy and inexpensive

By Deb Hipp for Next Avenue

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Credit: Adobe Stock

When my dog Toby was 11, I checked out a book on anti-aging for dogs from the library. I left to run a few errands and returned later to a grisly scene.

I found the mangled book on the floor, cover gnawed off, two chapters torn apart and puncture wounds to the appendix. Apparently, Toby didn’t intend to age gracefully.

I’d adopted Toby, a Lab/chow mix, from a shelter six years earlier. Toby’s feisty personality soon emerged. He raced up and down stairs and barked ferociously whenever a stranger approached the door. He was my big, protective dog. And then one day, he wasn’t.


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Can you self-insure for long-term care?

It might be within reach if you take these steps

By Chris Farrell for Next Avenue

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The odds are worrisome. The typical 65-year-old can expect to live another two decades and has a 52 percent chance of needing some type of long-term care services and support at some point.

According to Melissa Favreault of the Urban Institute and Judith Dey of the U.S. Department of Health and Human Services, the average tab for long-term care is $138,000. Medicare covers hardly any of that cost. Medicaid does, but only for the impoverished.

Insurance is the classic financial planning solution for handling an uncertain risk that comes with a potentially large price tag, yet only about 10 million Americans have long-term care insurance, according to the American Association for Long-Term Care Insurance.

Put somewhat differently, 3.2 million boomers celebrated their 65th birthday last year while the insurance industry sold only 100,000 long-term care insurance policies. Problem is, the relatively small number of insurers that write long-term care policies have been hiking premium prices and reducing benefits. The effect: long-term care insurance policies are too expensive for many modest and middle-income households.

What if you’re among the millions of boomers who find the cost of long-term care insurance too steep for your household budget? Are there viable alternative strategies — ways of creating your own DIY insurance plan? Yes, but it takes planning and creativity.

Where to start? By starting

What can you do on your own to protect yourself against potential long-term care expenses? You can build a healthy margin of financial safety by focusing on savings and spending, especially by thinking through your living arrangements in your elder years. You’ll also want to carefully evaluate your support system of family and friends, as well as investigate the convenience and cost of long-term care services in your community.

“You need to proactively plan and not just wait,” says Robyn Stone, executive director of LeadingAge in Washington, D.C.

Ross Levin, a Certified Financial Planner and founding principal of Accredited Investors in Edina, Minn., adds, “The key is to reduce risk.”

Savings help, of course. But if you’re in your 50s or 60s, don’t worry too much if you’re not flush with savings yet. You still might have another two to three decades to increase your savings; long-term care expenses usually don’t kick in until around age 80.

You can probably find at least some money to set aside with the kids out of college. Many boomers are earning an income well into the traditional retirement years, usually from part-time and contract work.

“Start thinking, ‘Can I put a little more money aside than I have been?’” says Howard Gleckman, senior fellow at the Urban Institute, and an authority on long-term care costs.

Hold on to home equity

The really rich lode of potential savings is on the spending side of the equation.

Years ago in an interview, Harry West, now chief executive officer of Frog Design, captured an insight about spending that belongs at the core of any DIY plan for financing long-term care: “When you talk to boomers, what you find is that freedom [from debt] is really, really important,” West said. “Freedom is a low overhead.”

Jonathan Guyton, a Certified Financial Planner and principal at Cornerstone Wealth Advisors in Edina, Minn., puts a practical spin on that view. “Look at your expenses,” he says. “This isn’t fancy stuff. But if you plan well, you’ll have more resources.”

The key decision is where to live. After all, the home is the single largest expenditure for most households. “At home” is also far and away the most popular answer to where we want to be as we age. In a recent AARP survey of 1,600 people 45 and older, 73 percent said they would like to stay in their current residence.

With that goal in mind, it pays to get rid of your mortgage if you can. Among the 65-plus population, 65 percent own their home free and clear.

You don’t want to tap your home equity, either, since it’s the foundation of the household safety net. “Maintain your home equity until you really need it,” says Gleckman.

That said, “aging in place” at home isn’t necessarily the best idea when fashioning a DIY long-term care plan. Remember, these expenses typically begin in your 80s, a time of life when social isolation is a growing concern, especially if mobility is limited.

“How much does aging in place become stuck in place?” asks Stone. “You don’t want to be lonely.”

Housing with community and cost-sharing built in

Stone recommends looking at co-housing, cooperative housing, home-sharing, shared residences and other communal living arrangements that reduce the overall cost of living and offer a built-in community. These living arrangements have largely operated on the society’s fringes, but they’re moving toward the mainstream.

“It’s not too late to plan to live in a community and to be more efficient with resources,” Stone says. For instance, home sharing involves renting out a room or part of the home to housemates, a way to bring companionship and additional income into the home.

Co-housing communities are another intriguing alternative. The community is planned by a group of people who choose to live together. It typically has large common spaces, such as a dining room, kitchen and garden and each household owns its own small place for independence and privacy. The financial advantage of co-housing lies in sharing some tasks and costs, such as grocery shopping and cooking meals. Everyone saves on his or her utility and maintenance costs.

A survey of 200 co-housing residents found a minimum monthly cost savings of $200 per household, according to the Fellowship for Intentional Community. At an annual compound rate of 2 percent, that adds up to nearly $27,000 in 10 years.

The co-housing model and similar communal arrangements are not the kind of long-term care you’d find in a nursing home. But they do offer a creative, low-cost way for neighbors to take care of neighbors.

When Charles Durrett, 60, an architect and co-author of Creating Cohousing: Building Sustainable Communities who lives in a co-housing community in Nevada City, Calif., recently fell and hurt his leg, he put out an email that he needed crutches and several were soon at his door. Residents would willingly bring a meal to his home if he needed it. In a number of communities, Durrett says, residents will share the expense of a professional caregiver.

“Co-housing is not only the best solution I know, it’s the most favorable from a quality-of-life point of view,” he says. “I’ve watched how seniors take care of each other.”

Living with less, happily

There are other ways to reduce living expenses and add to cash flow. It’s well documented that people spend less on stuff as they age, including clothes, jewelry and furniture.

People in their 60s and 70s do engage more with experiences, like travel, taking art lessons, volunteering in the community, mentoring younger workers and spending time with friends and family. In other words, embracing a frugal or thrifty lifestyle doesn’t signal a lower standard of living — far from it.

A letter writer to The New York Times several years ago put it nicely: “You can get by on a lot less when you’re retired, without really depriving yourself of anything important,” he said. “If I had known earlier how much ‘wealth’ derives from such simple pleasures, I would have retired much sooner.”

A 2014 survey by the mutual fund company T. Rowe Price bears this out. Among the boomers who’d retired in the previous five years, many reported that their households were living on less than the 70 to 80 percent of pre-retirement income that financial planners and retirement experts assumed they would need. Four out of 10 were living on 60 percent or less of their pre-retirement earnings.

Disaster, right? Hardly. Despite their reduced incomes, these retirees said they were satisfied with how they were doing and agreed they “don’t need to spend as much” as they did before.

Add a thin layer of long-term care insurance

You’ll also want to talk to your children, relatives and longtime friends about long-term care. How much can you realistically rely on them to help out if needed? In addition, you should research what kinds of services for long-term care are available in your community, basics like transportation but also opportunities to engage with people in the area. “Think about community in ways that take advantage of generations,” says Stone.

Now, I want to circle back to long-term care insurance. Let’s say you’ve embraced this basic DIY plan that involves working a bit longer, spending a bit less, saving a bit more and placing yourself into a community of mutual support. At this point, revisit the idea of purchasing long-term care insurance. Does it make sense to add a thin layer of coverage on top of your DIY plan?

You can lower the monthly premium by opting for a benefit that lasts for less than five years with a reduced daily benefit, for example. “You’re filling in a gap,” says Guyton.

Here’s the kicker: The elements that go into a DIY long-term care financing plan include everything that all of us, except for the wealthiest sliver of society, need to think about regardless of long-term care as we enter the second half of life.

© Twin Cities Public Television – 2017. All rights reserved.

Gardening when you’re not yet in shape

This spring, follow these tips to avoid injuring yourself

By Linda Melone, CSCS for Next Avenue

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Credit: Getty Images

Warmer weather and the smell of spring in the air provides major motivation to get outside and dig in the garden — an enjoyable exercise that doesn’t involve a treadmill. Pushing a mower, pulling weeds, digging holes and carrying soil require the use of muscle groups in the entire body. But if you’ve been lounging around for most of the winter, all that bending, digging and planting can wreak havoc on your body, especially when you’re over 50.

Laying the groundwork

“You need to know your limitations,” says Matthew Cauliffe, physical therapist with Professional Physical Therapy, which has locations in the New York metropolitan area. “You’ll want to avoid any activities that aggravate pain. And if you do not regularly perform heavy lifting, bending or squatting, you should begin easy and progress as tolerated.”


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The quiet blessing of grief that never ends

This writer finds beauty in the pain she feels over the loss of her sister

By Jill Smolowe for Next Avenue

Credit: Getty Images

Credit: Getty Images

In the almost seven years since I laid my husband to rest, followed barely a year later by the loss of my sister and mother, I’ve developed an appreciation for just how unpredictable and, well, amazing grief can be.

I’m not talking about the period of hollowing when the shock and fog of loss clouds every thought and informs every waking (and perhaps sleeping) moment. No, I’m talking about the grief that comes after that. After the deceased loved one’s absence is no longer a constant presence. After the acute ache subsides and then, unthinkably, stills. After life moves forward, opening new melancholy-free vistas that trace no connection to the departed.

The grief I’m referring to lays claim to no stage and holds no hope of being put behind. Even on the happiest days, it lies patiently in wait for some quirk of logic to unleash it. A scent. A song. A glimpse of an almost-familiar face. Suddenly — whap! — you’re puddled in a heap, sobbing and thinking, WhatTheWhatThe.


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The 5 exercises you should do every day

Improve your range of motion and balance in less than 10 minutes

By Rashelle Brown for Next Avenue

Credit: Thinkstock

Credit: Thinkstock

Balance and mobility training can benefit us at any age, but it becomes more important as you reach and pass the age of 50.

Maintaining joint range of motion allows you to move naturally and helps to combat the postural problems that cause neck, back, shoulder and hip pain.

Far from only preventing stumbles and falls, balance training is extremely important for everyone because it makes us better at every physical thing we do. Having a keen sense of proprioception (the sense of where your body is in space) makes all movement more efficient. When combined with fluid joints that allow for a full range of motion, this puts you at your functional best.

Here’s a short sequence of five exercises you can do every day to improve and maintain your balance and mobility. Done in a slow, controlled fashion, you can finish the whole workout in under 10 minutes:


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Residents discover hidden talents

Don Lloyd and Perry Hunsley highly recommend Gina's class. 

Don Lloyd and Perry Hunsley highly recommend Gina’s class.

“I’m a terrible artist.”
“Don’t look at mine.”

Gina Lee hears these statements over and over, from art students in their teens up to their 90s. But Gina doesn’t let those beliefs persist. She knows that with a few basic techniques and encouragement, we can all discover our inner artist.

For almost a year, Gina has been visiting Salina Presbyterian Manor once a month to guide our residents through an art project. She has a small, devoted core of regular members, and many others drop in to see what it’s all about, sometimes after seeing the latest creations on display in the resident gallery.

“Gina makes it fun and puts everyone at ease. We learn something new every time,” said resident Don Lloyd.

Don and the other art students can thank Chaplain Mary Bridges for bringing Gina to our community. Mary’s daughter used to work with Gina at South High School. Today, Gina teaches art at South Middle School. Last year, Mary asked Gina if she would offer a regular class at Presbyterian Manor.

“I was thrilled. I had gotten my certification so I could work with hospice,” Gina said.

Gina received her degree in art from Fort Hays State University and has taught middle and high school students for many years. But she has enjoyed working with older adults, ever since she was a child.

Growing up in a small western Kansas town, Gina became very close to the retired people in her neighborhood, especially one couple down the block. “It was nice to have them as ‘extra’ grandparents because my mother’s family lived really far away,” she said.

Gina and her parents would also visit people at the nursing home in Oakley every Sunday. They didn’t even have a relative living there. “We knew all the residents names. I would play piano for them,” she said. “I didn’t have an aversion to nursing or retirement homes. That’s where the fun people were. That was my parents’ attitude: we were going to visit our friends.”

Later, Gina was able to combine her experience with older adults and techniques she learned from teaching art to kids with special needs. She knows how to adapt her lessons for people with low vision or difficulty holding a paintbrush.

“I had to find projects that are not long and exhausting but that are still challenging. I hope I’ve done them justice,” Gina said. “I see very creative people who are excited to talk about what they’re doing.”

Her students say Gina does a great job of creating that excitement. Resident Perry Hunsley said he enjoys the class because Gina is “innovative, lively and pretty.” Kim Fair appreciates that Gina explains the projects thoroughly. “She follows each artist’s progress, always encouraging us to go in our own direction,” Kim said. “We all feel fortunate to have her expertise and support in expanding our horizons.”

It’s important to Gina that residents know they’re making real art. “I tell them this is a great way to get the brain thinking in a different way.”

Gina’s monthly Art Class is open to all residents. Take Don Lloyd’s advice and give it a try: “If you had her as a teacher in school, you wouldn’t play hooky — she is that much fun.”

Chaplain: Mary’s musings

shutterstock_557438314By Mary Bridges, Salina Presbyterian Manor chaplain

I love buttons! I have a button heart pin that I made, a button necklace and earrings, a button tie and button vest. One year I made special button sweatshirts for myself, my daughter and granddaughters. At the antique shop in Russell they have an old wash tub filled with buttons. Oh, how I love to dig in the tub and look for special buttons.

One of my earliest childhood memories is playing in the attic at my grandmother’s house. My grandmother came to America when she was 16 years old. She had 15 children and lived to be 99 years old. She didn’t have any toys at her house but oh did we have fun in her attic, where we played with her old wooden spools. My cousins and I would have contests to see who could build the highest tower. But my favorite thing to play with was her button box. She had the most wonderful collection. I could play for hours with those buttons. She’d thread a needle with a long string, and I could spend hours making strings of buttons; some would be dark colors, and some all white, but my favorite were the multi-colored ones.

As I got older I’d sometimes make up stories about the buttons and what kind of clothes they’d been on. Maybe this one filled with rhinestones belonged to a Russian princess. Could this gray one had come from the work shirt of my grandfather, whom I never knew? And, I think this one came from my Grandma’s dress that she wore to church. And, perhaps this tiny button was from some clothes that my dad wore as a baby. Did this tiny pearl button come from a wedding dress? Some were almost weird looking, and it was hard to figure just what their purpose was.

When you think about it buttons are a lot like people. Buttons come in all colors, all sizes and all shapes. Some may be chipped or broken, but they still function. Some are simply decorative and aren’t meant to fasten anything; they’re just plain pretty. Each button is created for a special need. Sometimes we only need one button on our clothing, but most times it takes several. Some clothing has buttons not only on the front or back but also on the sleeves and collars.

People also come in a variety of shapes, size and colors. Sometimes it takes only one person to do a job, but there are other jobs that take many people working together. People working together can accomplish marvelous things.

Remember, alone, we can’t always achieve or accomplish much. We may be like that single button, a bit weird or perhaps a bit shabby, or chipped and not quite sure where and when we will be used. One single button cannot hold a shirt closed. But together with others our single voices can become a powerful statement. Together, we can and do make a difference in our world. Remember, to the world you may be one person, but to one person you may be the world.