Gratitude Linked to Positive Emotions and Good Health

Studies show gratitude increases a sense of well-being and happiness, as well as boosting the immune system and heart health.

Studies show gratitude increases a sense of well-being and happiness, as well as boosting the immune system and heart health.

Some of us grew up with parents encouraging us to eat our vegetables by telling us that children were starving in China. In other words, be grateful that you have boiled carrots and peas to eat. We may not have made the connection when we were young, but as we grew older, many of us adopted the practice of bowing our heads and giving thanks for the food on the table.

While many religions have emphasized gratitude for centuries, research is giving the concept renewed attention by showing its many health benefits. Studies indicate that positive emotions and actions, such as happiness, optimism and being sociable, can reduce stress and therefore decrease disease and promote longevity.

Benefits of Gratitude

Many studies link grateful feelings or actions to improvements in physical and emotional health. According to research, gratitude:

• Strengthens the immune system and lowers blood pressure
• Raises levels of positive emotions
• Creates more happiness and optimism
• Decreases aggression
• Reduces loneliness and feelings of isolation
• Boosts heart health
• Improves relationships, both with old and new friends as well as spouses/partners
• Decreases aches and pains
• Improves sleep
• Increases empathy
• Boosts sense of well-being
• Improves self-esteem
• Helps overcome trauma disorders

Grateful people tend to be more optimistic, a characteristic that researchers say boosts the immune system. Also, grateful and optimistic people tend to be healthier because they have the energy and motivation to exercise more, eat a healthier diet and get regular physical exams.

When people thank others, they are widening their circle and seeing themselves as part of a larger world. Such feelings are linked to a healthier outlook on life and better health.

Website Embraces Gratitude
gratefulness.org

There’s even a website dedicated to gratefulness. The sponsoring organization was cofounded by a Benedictine brother, David Steindl-Rast, who writes about how he learned to be grateful while growing up during World War II in Germany. ”Towards the end of the war, we had nothing to eat. We were just really starving . . . and when you have so little, you are so much more grateful for the little that you have.” He points out that poor people are usually more grateful than rich, because “their vessel is very small. The smallest thing makes it already overflow; and this sparking of life, this joy of life, is the overflow. It’s the overflowing with gratefulness and thankfulness.”

The website offers a daily question that Steindl-Rast answers, monthly Grateful News—in February reporting on the California desert blooming after a drought, the election to the British Columbia legislature of its first aboriginal female member and an Oklahoma restaurant owner who extended an invitation for a free meal to homeless people—a library of resources, a variety of sample practices and the opportunity to network with others.

Where Do You Start?

Being grateful is not always easy, especially if you are going through hard times. In fact, getting older makes gratitude more difficult because of age-related challenges: losing friends, decreasing physical abilities, worrying about money or perceiving our lives as diminished.

At this time of life, it’s even more important to focus on what there is to be grateful for: new grandchildren, a sunny day, a good meal or close friends. In fact, research has shown that people who endure major life challenges—fighting cancer, watching a loved one die or even living through 9/11—often learn to appreciate the small things. One man battling lung cancer walked out of the hospital one day and was enchanted by the song of a bird.

Even forcing yourself to be grateful can have results, experts say, pointing to a famous study in which people were told to hold a smile for 20 seconds. Even if they weren’t happy, just the physical action made people feel better.

Here’s a few ideas to get you started:

Keep a gratitude journal. Every day, write down who or what you are grateful for. This can include small things, like someone opening the door for you at a store or restaurant. Record your appreciation for a good job, your health or a gorgeous sunset.

Thank others. This can be in the form of a thought—a silent acknowledgement of someone who has helped you—or as a note or phone call to express your appreciation.

Pray or meditate. Praying or focusing on the present moment can often engender feelings of gratitude. Many religions emphasize, often with prayers, the importance of gratitude.

Look back. Call to mind those who have helped you in the past: grandparents, a teacher, neighbor or friend you’ve lost touch with. In your life, you’ve had many encounters with people who touched you in some way. Be grateful for them.

“Grateful living is a way of life which asks us to notice all that is already present and abundant—from the tiniest things of beauty to the grandest of our blessings—and in so doing, to take nothing for granted. . . . Small, grateful acts every day can uplift us, make a difference for others, and help change the world”

— Gratefulness.org

There’s No Reason to Save All Your Financial Records

You only need to keep some statements and bills for a year.
Tax season is a good time to throw away unnecessary documents
—and get rid of some clutter.

While filing your 2015 taxes and digging through years of receipts and old files, you may wonder if you really need to keep all your documents going back to the time when the Beatles sang “I Wanna Hold Your Hand.” So what can you get rid of? Experts say you need to keep some records forever, but you can dispose of others after a few years.

Tax Documents

The IRS advises you to save your tax returns for a minimum of three years. Generally, the tax agency can audit you three years from the filing or due date of the return, and you have three years to claim a refund. However, if you failed to report more than 25 percent of your gross income, the IRS has six years to assess an additional tax, and if you don’t file a tax return at all, there is no statute of limitations.

However, many financial experts say you should save your returns forever. MarketWatchtells the story of one man preparing to retire who discovered that his Social Security record showed he was short by two years for retirement benefits. Unfortunately, he had shredded all the tax returns that would have shown he had worked enough quarters to qualify for benefits immediately. He couldn’t get help from IRS records either, because the tax agency didn’t have electronic transcripts going that far back. So he ended up working two more years to qualify.

Another reason to keep your tax returns is that they can be helpful when settling estates, applying for a mortgage or disability insurance, or tracking down the value of certain assets. In fact, some creditors and insurance companies require you to keep records longer than the IRS does.

Also save supporting documents for at least three years, although some experts say to keep those forever, too. Documents can include copies of your W-2 forms; 1099 forms reporting interest, dividends, capital-gains distributions and other income; canceled checks and receipts for charitable donations; and records showing eligible expenses for other deductions and credits (and eligible expenses for health saving accounts and 529 withdrawals).

Retirement Plans

Keep records showing how much you deposited and withdrew from your IRA and 401(k) accounts. Don’t shred your IRA Forms 8606 until you withdraw all of the money from your individual retirement account(s). You may need them to prove you’ve already paid taxes on the contributions and won’t be taxed on them again. Experts say to keep tax forms for retirement accounts such as IRAs until seven years after the account is depleted.

Stock and Mutual Funds

Hang on to your quarterly investment statements until you receive your annual statement so you can check to make sure they match. Experts say to keep annual statements for three years after you sell the investments.

When it comes time to sell your stocks or mutual funds in taxable accounts, you’ll need the original records showing the purchase date and price so you can establish the cost basis and determine whether it’s a loss or gain. Although brokerages are required to report the cost basis of stocks purchased in 2011 or later and mutual funds and exchange-traded funds purchased in 2012 or later, it’s helpful to keep your own records, especially if you switch brokers.

Your Home

As long as you live in your home, keep the records showing the purchase price of the home as well as how much you spent on improvements. For one thing, if you make a nice profit on the sale of the home (more than $250,000 for those who are single and more than $500,000 for couples), you can reduce your tax bill by subtracting the cost of major home improvements (not repairs). Also, potential buyers may want validation for any home improvements you did. After you sell the house, keep the sale documents for three years as documentation for capital-gains tax.

Make sure you keep receipts and warranties for major household items, such as furniture, appliances and electronics, so you can return the items if needed. You can get rid of a warranty when the coverage period has passed, and the receipt when you no longer own an item.

If you have property at home, such as office equipment used for a small business that you may want to amortize, depreciate or sell, you may want to keep the sale records until the statute of limitations expires for the year in which you dispose of the property.

How to Safely Store Documents

For documents you need to save, experts stress that it’s important to have a good system, not least because you’ll be able to find them easily if you need them. In an electronic age, you now have two choices for where to store crucial documents: in a traditional file cabinet or safe deposit box, or on your computer or the cloud.

Always store important papers, like birth certificates, in a safe deposit box or other fireproof container. A paper filing system with labeled folders needs to be well organized, as does a system online.

If physical space is tight, you can scan your documents and save them digitally on your computer. However, you need to back up electronic files, either on a hard or storage drive, or on a Web storage site, such as Dropbox. Make sure the online storage site has a good reputation, encrypts the information and offers automatic backup and good technical support.

Increasingly many financial institutions, including banks and brokerages, provide online access to customers’ account statements for a few years, so you can always check your records online (or download them onto your computer) without keeping paper statements.

When it comes time to get rid of monthly bills or receipts, to lessen the risk of identity theft, make sure you shred the documents rather than dump them in the trash.

Insurance records. Keep policies that you renew each year, such as those for your home, apartment or car, until you get new policies. Then get rid of the old ones, although some experts advise holding on to the old polices for three years.

Purchases. You can hang on to your sales receipts until you receive the credit-card or bank statement (if not paying with cash) or until the warranty or return period expires. However, if you need the sales receipt for tax purposes, you should keep it for three years.

Paycheck stubs. Keep for one year, until you can compare stubs to your W-2 and annual Social Security statement at the end of the year.

Utility bills. Keep for one year, unless you have a home office and you’re filing these expenses as a deduction, in which case you need to keep the bills for three years after you’ve filed your tax return.

Bank accounts. Keep canceled checks and bank statements for one year, until you finish your taxes, unless you need them to prove deductions, in which case you should keep for three years. After you reconcile your deposit and ATM receipts with your monthly checking and saving account statements, you can discard them.

Credit card receipts. Keep for one year, unless you need the receipt to support a tax deduction, such as for a charitable contribution, in which case you need to keep for three years.

Vehicle records. Hold on to purchase receipts, titles and registration information as long as you own the car, boat, truck or other vehicle.

Crucial documents. Records that you should store forever and in a safe place include marriage licenses, birth and death certificates, wills, records of paid mortgages, Social Security cards and military discharge papers.

Credit card receipts. Don’t dispose of loan information until after the mortgage, vehicle, student or other loan is paid off.

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Medicare to Pay for End-of-life Talks with Doctor

Under a new law, patients can discuss their medical options and goals in order to make an informed decision on the type of care they want.

For the first time, Medicare will pay this year for a conversation with your healthcare provider about your end-of-life care. When Congress attempted this coverage six years ago, it was met with charges that such conversations would result in “death panels.” Yet polls show that a majority of Americans want to talk to their doctors about their options and preferences as they approach the end of their lives. A recent Kaiser Family Foundation survey found that about 9 in 10 adults say doctors should discuss end-of-life care issues with their patients, yet only 17 percent of adults say they have had such a discussion.

Even though most adults (90 percent) say they would prefer to receive end-of-life care in their home if they were terminally ill, only about one-third of Medicare beneficiaries (age 65 and older) died at home (Kaiser Family Foundation). Conversations with healthcare provider about such wishes could guide you and your doctor to the kind of treatment that would ensure you die where you want.

Under the new rule, Medicare pays $86 for the first 30 minutes of “advance care planning” in a doctor’s office and $80 for the service in a hospital. In both settings, Medicare will pay up to $75 for 30 additional minutes of consultation. If the discussion takes place during your annual wellness visit, it is considered a preventive service and the patient’s coinsurance and deductible are waived. These voluntary discussions can take place at any time, not just when a patient is facing a serious illness or death.

Ideally, end-of-life conversations would cover a range of concerns, including understanding the patient’s prognosis and goals. Do you want everything done that would keep you alive—chemotherapy, CPR, tube feeding—even if it doesn’t meet your wishes for your end of life? Be specific about treatments and interventions you do and do not want.

Benefits of the Conversation

Far from forcing people to accept treatments that would shorten their lives, communication with your healthcare provider can help ease your fears, minimize pain and suffering and enable you and your family to experience a peaceful passing. Those who are dying often have many fears—of pain, indignity, abandonment and the unknown. By talking to your healthcare provider, your end-of-life care can become an experience of choice rather than passivity, of empowerment rather than powerlessness, experts say.

An end-of-life conversation allows your loved ones to know what to expect and know that you are receiving the care you desire. The new policy will help seniors “make important decisions that give them control over the type of care they receive and when they receive it,” the Centers for Medicare and Medicaid Services stated.

Studies have shown that advance-care planning improves the patient’s quality of care because it’s targeted to what the person wants. Directed treatments can reduce the costs of medical interventions that the patient either doesn’t want or doesn’t need.

One Woman’s Story

For Amy Berman, a nurse, being able to have such conversations with her doctors “allowed me to survive, and live well, in the five years since my diagnosis” of a fatal form of breast cancer.

“Faced with an incurable disease and a prognosis where only 11 to 20 percent survive to five years and there is no statistic for 10-year survival because it so rarely happens, I came to understand that my priority was to seek a ‘Niagara Falls trajectory’—to feel as well as possible for as long as possible, until I quickly go over the precipice. Quality of life is more important to me than quantity of days, if they are miserable days.”

A nationally recognized expert in care of the aged and a senior program officer at the John A. Hartford Foundation, Berman wrote about her experiences in her blog. She chose a course of treatment that “slow[s] the cancer’s spread with the least amount of burdensome side effects,” while rejecting chemotherapy drugs, a mastectomy and radiation therapy recommended by one doctor who never asked what mattered to her in her life. Such radical treatment would have “compromised the quality of my remaining life without any real benefit.”

Even though her cancer has spread a bit farther, “because my treatment focuses on helping me live well and feel well, I haven’t been in the hospital. I feel great.” Berman estimates she has “saved about a million dollars by avoiding care I do not want,” while being able to work full time, travel and spend time with family and friends.

Suggestions for Your Talk

Lining up Your Documents

Going hand in hand with the end-of-life conversation with your doctor is the preparation of your advanced care directives, which can include a living will, Five Wishes and/or POLST (physician order for life-sustaining treatment).

A living will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as other decisions such as pain management or organ donation. Five Wishes goes beyond medical care to share your personal, emotional and spiritual concerns. The form includes questions about how comfortable you want to be, how you want people around you to treat you and what you want your loved ones to know when you’re facing the end of your life. These documents also indicate who can make decisions on your behalf if you’re unable to do so.

Unlike a living will or Five Wishes, a POLST form is a medical order signed by a doctor and based on your end-of-life care wishes. It is used by emergency medical professionals, hospital staff, a healthcare facility and others to follow your instructions. Oregon’s POLST lets people register their wishes for end-of-life care with a state registry. Several states, including New York, Washington and West Virginia, have also adopted a version of the POLST.

Although Medicare has not provided any guidelines for a conversation about end-of-life care, others have. Dr. Atul Gawande is the leading thinker and writer on this subject. In his influential book Being Mortal, he talks about asking his patients what makes their life worth living. He goes far beyond what most doctors consider a conversation about end-of-life care, which usually involves resuscitation, mechanical ventilators and comfort care.

One patient said he would enjoy life if he could eat chocolate ice cream and watch football. For some people being able to be at home and spend time with grandchildren is important. Others don’t want to continue their lives if they can’t be active. Different answers result in different treatment plans; for example, less or more aggressive cancer treatment.

Gawande poses five questions for patients facing life-threatening illnesses:

1. What is your understanding of where you are and of your illness?
2. What are your fears or worries for the future?
3. What are your goals and priorities?
4. What outcomes are unacceptable to you? What are you willing to sacrifice and not?
5. What would a good day look like?

“Asking these allows everybody to understand what the goal really is,” he says. ”What are you really fighting for?”

The Conversation Project, an organization dedicated to helping people talk about their wishes for end-of-life care, poses slightly different questions for patients to ask their doctors:

• Can you tell me what I can expect from this illness? What is my life likely to look like six months from now, one year from now and five years from now?
• What can I expect about my ability to function independently?
• What are some possible big changes in my health that my family and I should be prepared for?
• What can I expect to improve (or not improve) if I choose this course of treatment, or another course of treatment?
• What can I expect if I decide to do nothing?

When meeting with your doctor, you can also discuss palliative care, which is concerned with providing seriously ill patients with relief from the symptoms and stress of a serious illness, rather than trying to cure the patient. It can be relief from pain, fatigue, constipation or depression, for example. The purpose is to improve your quality of life.

Once you’ve had the conversation with your doctor, follow up with your family and close friends and let them know your preferences, so they can honor your wishes.

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Spring forward to fight Alzheimer’s

Time is everything in the fight against Alzheimer’s disease, and we lost an hour when we set our clocks forward last weekend. That’s an hour of crucial research. An hour to offer support to someone living with Alzheimer’s. It’s an hour we can’t afford to waste.
Help us reach our goal by March 31.

That’s why we’re setting a goal to raise $60,000 by the end of March — $1,000 for every minute we lost. Please give as generously as you can right now.
For too long, people thought Alzheimer’s was just a part of aging. Your gift will help us make up for lost time in the search for promising methods of treatment, prevention and, ultimately, a cure — and help us offer care and support to people affected by this disease. We can’t do this without you.
Make a donation today to offer help and hope to those affected by this deadly disease. Thank you.
Sincerely,

Donna McCullough
Chief Development Officer

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Caregivers find ways to communicate with people living with Alzheimer’s

The changes in a person with Alzheimer’s disease impact various aspects of communication, including language. The person’s ability to say what he or she wants — and decode what others are saying — may become increasingly difficult as the disease progresses.

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