Protesting for the Right to Sit

A 3-day festival featuring 1970s rock stars bans blankets and chairs. Will baby boomers stand up for their rights?

A 3-day festival featuring 1970s rock stars bans blankets and chairs. Will baby boomers stand up for their rights?

When a concert promoter sold tickets to an October 2016 music festival aimed at baby boomers, it promised customers that they could bring their own seating. The Desert Trip festival’s stars include Bob Dylan (who just turned 75), Paul McCartney (73), the Rolling Stones (Mick Jagger and Keith Richards, both 72), The Who (Roger Daltrey is 72 and Pete Townshend 71) and Neil Young (only 70). After customers paid $424 each for tickets to the 3-day Desert Trip, in Indio, Calif., they received notice that neither blankets nor chairs would be allowed. For those with creaky knees, aching backs and/or sore feet, this festival wouldn’t be any Woodstock.

Writing on Alternet, author Peter Dreier has called the no-seating policy a form of age discrimination and is urging baby boomers to protest by staging a sit-in, a popular type of protest from the 1970s, at the home of Jay Marciano, chairman of concert promoter AEG Live.

Although AEG Live later announced it would refund money to those who didn’t want to stand for three days, it wouldn’t back down on its ban on chairs. Will baby boomers take this latest affront sitting down? Will those who protested the Vietnam War and demonstrated for civil rights now stand up for their right to sit?

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Tech 101

Use Your Smartphone to Pay at the Store

Storing credit cards on your phone is safer, experts say, than in your wallet, which can be lost or stolen.

Storing credit cards on your phone is safer, experts say, than in your wallet, which can be lost or stolen.

Most of us grew up writing checks to make purchases, which can be a laborious task when you’re standing at the checkout counter writing in longhand (and then noting the transaction in the checkbook), and feel especially stressed if there’s a long line behind you.

When debit and credit cards replaced the checkbook for most retail transactions, it was a welcome and efficient step. But a new technology could make using debit and credit cards as antiquated as a checkbook. Mobile wallets or payments, as they are known, let you tap or wave your smartphone at a credit card terminal to make a purchase at your favorite store or restaurant.

You start by loading your credit and debit card accounts onto your phone, so they are stored on your phone instead of in your wallet. At the checkout counter, you verify your identity with either a fingerprint or pass code, choose the credit card you want to use and waltz out of the store with your purchase.

Amazingly, this new technology—in the form of Apple Pay, Android Pay or Samsung Pay—is touted as being more secure than physical credit or debit cards. Transactions use near-field communication (NFC) wireless connectivity, and the connection’s short range makes the transaction an unlikely target for hackers. On top of that, mobile payments have several security layers that make this option far safer than using a traditional credit or debit card that can be stolen or the information swiped by a store clerk or waiter.

A forerunner of the mobile-payment trend is Starbucks. Its mobile app lets you load money onto a Starbucks digital gift card, pay for items with your smartphone and accumulate rewards for free food or drinks. You can even use the app to order your mocha latte before you get to the store, so it’s ready when you arrive.

Not all merchants are set up to accept mobile payments, so check first to make sure. Your phone must also have an NFC chip, so your older phone may not be able to make mobile payments.

Apple Pay

One of the earlier and influential movers in the field of mobile wallets, Apple Pay can be used on iPhones, iPads and Apple Watches. To make a purchase, hold your Apple device near the reader with your finger on the Touch ID. Or, double-click the Home button when your device is locked to access Wallet.

Your card number is never stored on your device, and when you pay your debit or credit card, numbers are never sent to merchants. Apple Pay assigns a unique number to each purchase, so your payments stay private and secure. To make the transaction even more secure, if you lose your iPhone or iPad, you can put your device in Lost Mode (using the Find My iPhone app) to suspend Apple Pay, or you can wipe your device completely clean. You can also stop payments from your credit and debit cards by logging into iCloud.com.

Android Pay

Unlike Apple Pay, Google’s version of a mobile wallet doesn’t use fingerprints to authenticate your identity, but accepts a PIN code, password or pattern. To complete a transaction, tap your phone on the payment terminal and enter your pass code. Like Apple Pay, Android Pay uses “tokenization,” which replaces your payment cards’ real numbers with alternative numbers that are used just for that transaction. So, your credit card information is secure in case of a data breach.

Samsung Pay

Unlike Apple and Android Pay, you can use Samsung Pay at any checkout terminal that has a magnetic-stripe credit card reader because it’s not limited to NFC. Samsung Pay uses a technology that mimics the credit card swipe. This means you can use it almost anywhere. However, you must have service with a participating wireless carrier, including AT&T, Sprint, T-Mobile or Verizon Wireless.

Like the other two options, Samsung Pay uses encrypted software to hide your card numbers. To launch the app, swipe your phone, secure the transaction with your fingerprint or enter your pin, and hover your phone over the card reader to pay.

PayPal

Although not a phone, PayPal lets you access your credit and bank accounts without needing to use a credit or debit card. PayPal customers can make purchases at credit card terminals using their phone number and a PIN code. Like its online transactions and like Apple, Android and Samsung Pay, in-store purchases using PayPal are tokenized and encrypted.

PayPal has recently added an app for Apple, Android and Windows that lets you store loyalty cards (like those used at grocery stores) on your phone. With the new app, you can order ahead from a restaurant that partners with PayPal and pay with your phone, so when you arrive, all you need to do is pick up your pizza and get it home while it’s hot.

Not all stores have signed up for the PayPal partnership, so make sure you check for participating locations on your app.

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Early Diagnosis for Dementia Can Be Helpful

Watch for signs of dementia in your loved one, so together you can plan for the future before the condition worsens.

Watch for signs of dementia in your loved one, so together you can plan for the future before the condition worsens.

Someone you love—your parent, your spouse, a good friend—is showing signs of dementia: forgetting more often, being confused or perhaps exhibiting uncharacteristic behavior. You’re worried it could be Alzheimer’s or some other form of dementia, but because you know that nothing can be done, you keep quiet, hoping you’re wrong.

Benefits of Early Diagnosis

Yet discovering dementia early can be helpful for several reasons:

• You can reverse some cognitive problems that mimic dementia, such as depression or a vitamin B12 deficiency.
• Although there is no cure, Alzheimer’s medications can temporarily slow symptoms, improve quality of life and prolong independence, which also helps the patient’s caregivers.
• Slowing dementia’s symptoms with medication could reduce healthcare costs by delaying going into a nursing home. This also allows time to make decisions about future care and receive the patient’s input. However, waiting too long can cause problems because many facilities won’t accept those with severe dementia, at which point the family must scramble to find a place and may have to settle for an option that is inconvenient or doesn’t have the quality of care desired.
• Government or nonprofit agencies can provide support for the patient and caregiver. Services might include financial help and emotional counseling for both the patient and caregiver.
• The individual with dementia can have conversations with loved ones about what kind of treatment they want. They can fill out financial, legal and health advance directives before losing the ability to communicate. Without these directives, families often face wrenching decisions about their loved one’s care, such as what to do when the person can no longer eat or drink. If these conversations are put off too long, family members may have to go to court to take control of their loved one’s affairs, a costly and difficult process.
• Enrolling in palliative care can ease the effects of dementia. This specialized medical care provides relief from the symptoms and stress of a serious illness. Unlike hospice, palliative care is available at any stage of illness and can be combined with curative treatment. (For more on palliative care, see sidebar.)

Signs of Dementia

Palliative Care for Dementia Patients

Those with dementia face problems different than those with a physical disease, such as cancer. Because they often can’t express their feelings, dementia patients may be undertreated for pain. At the same time, they may receive interventions, such as forced food or drink, which might not be appropriate or helpful. Palliative care focuses on making sure the patient is comfortable, rather than trying to heal them.

A team of doctors, nurses, social workers and other specialists work together to improve quality of life for the patient, the family and caregiver, whether a spouse or family member. Statistics show that those taking care of loved ones with dementia have a much higher risk of getting sick themselves—even dying—compared to those not offering such care.

Many private insurance companies and health maintenance organizations offer palliative care benefits, while Medicare Part B offers some benefits. Medicaid’s hospice and palliative care coverage for people with limited incomes varies by state.

To help your loved one and yourself, watch for these indications of dementia. Dementia is a collective term, not a disease, that describes various symptoms of cognitive decline, such as memory loss. Alzheimer’s is the most common type of dementia, accounting for 60 to 80 percent of cases. Vascular dementia, which occurs after a stroke, is the second most common type.

Memory loss. As we age, it is common to not remember as well as we once did. But those with dementia forget the names of people close to them or major life events, like retiring or taking a big vacation. Not only can they forget what something is called but also its purpose. They may ask repeatedly for information or tell the same story over and over. People with dementia often get lost, unable to find their way to the grocery store or the retirement community’s dining hall. They misplace items or put them in inappropriate places, like storing a plate in the bathroom closet. They forget to pay bills.

Lapse in judgment. Those with dementia can make poor decisions, like donating money to every nonprofit organization that contacts them. The person might dress strangely, wearing warm clothes in summer, for example, or not shower or bathe. They forget what is appropriate, so they may barge into someone else’s house or apartment without knocking. Commonly, they lose inhibitions about sexual behavior, such as making inappropriate comments or exposing themselves.

Personality change. A sociable person can become withdrawn, or someone who is shy may suddenly start to do embarrassing acts, like removing her clothes in public. People with dementia often become more depressed, scared or anxious, and some become paranoid, certain that the caregiver is stealing. Moods can change swiftly, from calm to anger and back.

Difficulty with language. The person uses the wrong word for something familiar, like calling a garbage can a coffee maker. They might refer to the post office as “that place you take the mail.” Or they can’t find the word at all, so they stop joining the conversation or trail off in the middle of talking, as if they’ve lost their thought. Similarly, they have a harder time comprehending conversations and may need to have something explained repeatedly before they understand.

Tasks become difficult. Chores and activities that have been easy are suddenly challenging for people with dementia. The basics of cooking are now out of reach, washing clothes can be a stretch, and planning a big Thanksgiving dinner is impossible. Money management, especially, eludes them, so they don’t pay bills or correctly balance their checking account. Playing the person’s favorite game is no longer possible because they can’t remember the basic rules.

Other possible signs of dementia are changes in vision, so the person has a hard time reading; not knowing the time or date; and loss of motor functions, so walking becomes more difficult.

Best Vitamins, Minerals for Older Adults

A good diet is the best way to get nutrients, but sometimes you can’t get enough through food.

A good diet is the best way to get nutrients, but sometimes you can’t get enough through food.

Many of us have a daily regimen of vitamins and mineral supplements, often because we’ve read how a certain vitamin, for example, can boost our immune system. Yet studies have shown that eating the right diet is more beneficial than taking a supplement. Many foods also have fiber and other substances that provide health benefits. In addition, you may be wasting your money on expensive supplements that are not helping you, may interfere with prescribed medication therapies or could be harmful because certain supplements can be dangerous in large doses.

However, some people, such as strict vegetarians and vegans, may never be able to get enough of certain vitamins, such as vitamin B, in their diets. As we get older, we need to ensure that we are getting adequate nutrients, and diet alone may not be enough. Older adults might need supplements because our bodies become less able to absorb key nutrients. Some seniors cook less (or never learned how, in the case of widowers), plus we lose our sense of taste, or some foods become difficult to chew or digest. So we don’t eat as much.

For older adults, several vitamins and minerals are essential, whether you get them from your diet or from supplements. Check with your healthcare practitioner to know which ones are right for you.

B Vitamins

Vitamin B12 is important for creating red blood cells and DNA, and for maintaining healthy nerve function. Older adults can’t absorb it from food as well as younger people. In addition, commonly prescribed heartburn drugs, such as proton-pump inhibitors (for example, brand names Nexium or Prilosec), reduce acid production in the stomach, and acid is needed to absorb vitamin B12.

Vegetarians or vegans will not get enough B12 in their diet because it’s present only in animal products. Stomach stapling or other forms of weight-loss surgery interfere with the body’s ability to extract vitamin B12 from food.

Although many claims have been made that vitamin B12 prevents Alzheimer’s disease, heart disease and other chronic conditions, there is no evidence of this.

The National Academy of Sciences (NAS) recommends you get 2.4 micrograms (mcg) of vitamin B12 every day. You’ll find this vitamin in fortified cereals, meat, fish, poultry, eggs and milk.

Another B vitamin, B6, helps form red blood cells. NAS recommends 1.7 milligrams (mg) every day for men and 1.5 mg for women. You can get vitamin B6 from potatoes, bananas, fortified cereals, whole grains, organ meats (like liver) and fortified soy-based meat substitutes.

Too little folic acid/folate leads to anemia. NAS recommends 400 mcg each day for both men and women. You can get this essential B vitamin from dark-green leafy vegetables (like spinach), beans, peas, and oranges and orange juice. Also, many breakfast cereals are fortified with folate.

Vitamin D

Because it is mainly produced by sunlight, vitamin D is generally deficient in those who do not get outside. As we get older, we may spend more time indoors, especially in inclement weather, and our skin is less able to synthesize vitamin D. This vitamin helps the body absorb calcium, maintain bone density and prevent osteoporosis, and may also protect against some chronic diseases, including cancer, Type 1 diabetes, rheumatoid arthritis, multiple sclerosis and autoimmune diseases. In older people, vitamin D deficiency has also been linked to an increased risk of falling.

The NAS recommends at least 600 international units (IU) for people age 50-70 and 800 IU for those 70 and above. However, you should never take more than 4,000 IU. You can get vitamin D from fatty fish (such as salmon or tuna), fish liver oils, eggs, fortified milk and milk products, and fortified cereals.

Potassium

This mineral, which carries a slight electrical charge, is helpful with nerve impulses and is needed for all sorts of functions, including keeping your heart beating and your muscles working. Seniors who are taking diuretics, also called water pills, to control hypertension and congestive heart failure may lose too much potassium as they urinate. Too little potassium, which is an electrolyte, can result over time in fatigue, weakness of the muscles, headaches and changes in bowel habit.

The daily recommended dosage is 4,700 mg, although many older Americans don’t get enough potassium, according to surveys. You can find potassium mainly in fruits and vegetables, particularly bananas, prunes, plums and potatoes with their skin. Too much potassium also can be dangerous, so consult with your health care provider to be sure potassium levels are neither too high nor too low when taking diuretics.

Magnesium

As we age, we are less able to absorb magnesium, which can help prevent heart disease, diabetes and certain cancers, as well as osteoporosis. Some medications, such as diuretics, may also reduce magnesium absorption. The recommended daily dosage for women over 30 is 320 mg, and for men is 420 mg, but too much magnesium can be toxic.

Good sources of magnesium are fresh fruits, vegetables, nuts, whole grains, beans and seeds.

Calcium

Because calcium is so important for building and maintaining strong bones, it’s crucial that older adults get enough of this mineral. Too little will increase the risk of brittle bones and fractures. Post-menopausal women, especially, lose the ability to absorb calcium.

The National Institutes of Health (NIH) recommend 1,000 mg for men 51-70 years of age and 1,200 mg for women. Both sexes over 70 should take 1,200 mg, but not more than 2,000 mg a day. There are several types of calcium supplements. Calcium citrate and calcium carbonate tend to be the least expensive.

Calcium-rich food sources include milk and milk products, some forms of tofu, dark-green leafy vegetables (like collard greens and kale), broccoli, soybeans, canned sardines and salmon with bones, and calcium-fortified foods.

Controversial Supplements

Two other supplements get mixed reviews.

Are Supplements Safe?

Consumer Lab tested 38 multivitamins and found defects in one-third of them (“Defects Found in 33% of Multis Put to the Test,” July 27, 2016). Results showed 14 multivitamins contained either too little (as low as 8 percent) or too much (as high as 226 percent) of claimed amounts of vitamin A, vitamin C, folate or calcium. A range of multivitamins contained more than the upper tolerable limits of niacin, vitamin A, folate and magnesium. Interestingly, the test found that some of the best vitamins were also the cheapest. The more expensive products weren’t any better than those that cost less.

The problem is that the government does not regulate supplements, as it does medicine, to make sure they are safe or effective, because the U.S. Food and Drug Administration (FDA) labels supplements as food, not medicine. So, just because you see a dietary supplement on a store shelf does not mean it is safe, that it does what the label says it will or that it contains what the label says it contains. The FDA only gets involved when it receives complaints about a product.

Larger pharmacies, where product turnover is high, may be preferable over smaller pharmacies, because medications have an optimal period of time before losing their potency. In any case, make sure to check expiration dates before purchasing.

A few private groups, such as the U.S. Pharmacopeia (USP), NSF International, ConsumerLab.com and the Natural Products Association, have their own seals of approval for dietary supplements. To get such a seal, products must be made by following good manufacturing procedures, must contain what is listed on the label and must not have harmful levels of ingredients that don’t belong there, like lead. To be sure that the supplement you are buying is safe, check for the seals on the product. Or you can go to the NSF’s website to the see the list of supplements certified by the organization.

Multivitamins

While there is not sufficient evidence to support a recommendation for or against the use of multivitamin and mineral supplements, taking a daily multivitamin can help some people get the recommended amounts of vitamins and minerals, especially in situations when they cannot or do not obtain them from food alone. But taking a multivitamin can also raise the chances of getting too much of some nutrients, like iron, vitamin A, zinc, niacin and folic acid, especially when a person takes more than a basic, once-daily product that provides 100 percent of the daily value of nutrients.

Keep in mind that there is no standard or regulatory definition for multivitamins—or any dietary supplement. No agency regulates which nutrients they must contain or at what levels. (See sidebar, “Are Supplements Safe?”) Manufacturers choose which vitamins, minerals and other ingredients, as well as the amounts, to include in their products. If you decide to take a multivitamin, read the label to make sure you are getting the vitamins and minerals you need and in the right dosages for your age. Avoid supplements with mega-doses.

Omega-3

While some research suggests that a diet high in omega-3 fatty acids can protect brain health, a large clinical trial by researchers at NIH found that omega-3 supplements did not slow cognitive decline in older persons. However, these unsaturated fats have been shown to reduce symptoms in rheumatoid arthritis and slow the progression of age-related macular degeneration.

Instead of taking supplements, eat at least two servings of fish a week, especially salmon, tuna, sardines and mackerel. Omega-3 vegetable sources include soybeans, walnuts, flaxseed and canola oil.

When using supplements, remember to keep them away from heat, which breaks down their effectiveness. This is especially relevant when taking a car trip and you’ve stashed your vitamins in the car. Similarly, medications should not be stored above the stove.

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Research Symposium – Early bird prices extended to September 30!

Join us on ?Tuesday, ?October 11 at the Chicago Botanic Garden? for our Annual Research Symposium. You will ??gain knowledge and insights on Alzheimer’s and other dementia-related research topics? plus? ?increase your ?awareness and enhance your skill sets?. A special focus ?will be given ?on translating research into care. Register today to take advantage of early bird prices.

Join us at Chicago Botanic Garden!

Gain knowledge and insights on Alzheimer’s and other dementia-related research topics designed to increase awareness and enhance skill sets, with a special focus on translating research into care.

Where is it?
This year’s Symposium is being held at the Chicago Botanic Garden, located in the heart of the North Shore and convenient to downtown Chicago. The Garden provides attendees a serene setting with peaceful lakes and native woodlands.

Who should attend?
Split into tracks, the symposium is designed for:

• Attendee with early dementia or MCI
• Family, friend, or care partner of person with dementia
• Professional I (caregiver, direct care staff, administrator, non CEU/CME/CCMC)
• Professional II (health and allied health professional with CEU/CME, or case manager (CCMC))

Continuing Medical Education (CME) and Continuing Education Units (CEU) will be provided for healthcare professionals.

Receive early bird prices by registering online or over the phone 847-933-2413 today!

Featured Family Session Speaker

Beverly Sanborn, MS, LCSW

Gerontologist
Vice President, Program Development Belmont Village Senior Living

Featured Keynote Speakers

Alireza Atri, M.D., Ph.D.

Ray Dolby Endowed Chair in Brain Health Research
California Pacific Medical Center

Dean Hartley, Ph.D.

Director of Science Initiatives
Medical and Scientific Relations
Alzheimer’s Association

New – Free Expo!

Attendees

New this year – visit the free public expo featuring vendors and consultants who provide dementia-related services and education.

Sponsors/Exhibitors

Directly engage with symposium attendees, healthcare providers, physicians, families and care partners to showcase your research, business, products or services. New this year – we are opening the Expo to the general public at no cost. View and sign up for available sponsorships and exhibiting opportunities.

Learning Objectives

• Describe the common behavioral and cognitive changes due to disease progression.
• Recognize the importance of early diagnosis, and identify challenges in obtaining an early and accurate diagnosis of AD versus other causes of cognitive impairment.
• List common behavioral and neuropsychiatric symptoms of dementia.
• List evidence on modifiable risk factors for cognitive decline and corresponding prevention strategies.
• Review latest advances in utilization of biomarkers, diagnostic approaches and investigational therapies for AD, their mechanisms of action and clinical updates.
• Identify emerging strategies likely to drive future advances in Alzheimer’s disease.
• Indicate how Alzheimer’s disease affects society as it relates to health economics. Develop strategies for improving communication of referring families to supportive resources.

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