Be of good cheer! Or else! The pressure to have a good time during the holiday season can bring it’s own consequences. Stress to spend too much, to eat too much and drink too much has effects on mood and health. There is a national trend in the increase of heart attacks from Thanksgiving until after New Years. The reasons are many, including getting too busy to follow an exercise plan, unusual drinking habits and changes in diet. Even having one really big meal. Sudden high blood levels of fat can trigger arteries that are badly clogged. Unusual salt intake may retain enough fluid to stress a delicate circulatory system to trouble. High alcohol blood levels can irritate the heart directly and dangerously. The irregular beat can lead to stroke. Cold weather constricts the blood vessels on the outside of the body. Cold medicine can raise blood pressure.
Losing sleep, traveling, flu season and missing medications all contribute.
One of the biggest problems in identifying a heart attack is the difference in symptoms between men and women. Pain in the arm and chest is more likely for guys. Ladies may not hurt. They may have pressure, sweating and shortness of breath. One of the biggest contributors to fatal heart attacks is a delay in treatment. We can make it faster on my end with programs to get angioplasty started within 90 minutes of reaching the emergency room. The longest delays happen when a person denies the problem, takes an antacid and waits too long to go to the hospital. Another trend to improve survival is changes in how CPR is being taught. It’s easier than ever to learn and to do. And you can even take a class in using automated defibrillators! Clear!
Before that happens, keep your schedule intact. Sleep eight hours. Drink your water. Take your walks. Refill your prescriptions. And don’t ignore your symptoms. And be of good cheer.

There are two issues I think should be addressed this week. Both are related to the upcoming Thanksgiving Holiday. We hear about uncooked poultry and bacteria every year and it seems like everybody gets it, and then a new wave of food poisoning happens each holiday. A dear woman told me last week that her mother never taught her to cook a frozen turkey so she buys a fresh one every year. The woman is sixty-eight years old and I went to her mother’s funeral seven years ago. I think it’s time to learn on her own. The facts- you shouldn’t thaw a turkey (or other meat) on the counter. It takes about one day for every five pounds to thaw in the refrigerator. Then it can stay in the fridge for another two days. A fresh turkey should be bought the day before. No matter what the method of cooking (my wife like to brine, I like to deep fry) the center of the bird should be at 165 degrees F. Don’t get a pre-stuffed bird. Wash the bird, your work area and your hands every time! Those bleach infused towels do a good job of surface decontamination. Wash the pre-packed salads and spinach, even if the package says “washed.” The other topic is the point of the whole event. It is sometimes hard to stop and consider how much we all have. Many of us don’t count how many advantages we enjoy and just have an attitude of gratitude. Some families have a tradition of going around the table and saying “I’m grateful for…” on Thanksgiving. Some people don’t have a table to sit around. Some don’t have a family. Take a few minutes next week to think about whatever it is you are glad you have, to say thanks, to whatever your higher power might be, and to anyone around that day who might enjoy hearing it. And thank you dear reader, for your attention, time and effort each week.

Last week I recited some of my bona fides in respect to crime against older adults. The thing that surprises me time after time is the low return on crime.
Criminals that prey on older adults may get a quick claim deed now and then; sometimes they can arrange a loan against the senior’s home for a few hundred thousand. More often the proceeds of crime are just a few hundred or thousand dollars. Sometimes a lady can convince a well-heeled widower to buy her a car. Or a handyman persuades a woman to finance his daughter’s surgery- often back in the old country.
Younger adults become victims of crime because of greed. Older adults are more vulnerable because of sympathy and loneliness. The best protection they can receive is a full and satisfying social life. The best self-defense is to have a well-documented financial plan with a consultant on any large expenses or donations. Most importantly, in my opinion, is the willingness of a person to stand up and say, “I’ve been hoodwinked!” It can be embarrassing and frightening to realize and admit that someone you trust has taken advantage. Those feelings, and a well-meaning act of forgiveness can interfere with stopping the conman and protecting the future victims. And there will be other victims. If someone succeeds at this type of crime, they will try it again (and again). Knowing this may reduce the feeling of being special. Anger may lead to the courage to report. A professional criminal has professional level skills. It takes a professional to respond. The fraud detectives at the police and sheriff’s know how to find and nail these types. If someone is hurting you or someone you know, report the crime! If you don’t know how to ask a senior, try this: “Is someone hurting you?” A direct question is the best way to get a direct answer.

I haven’t ever explained the Elder Abuse Forensic Center. A grant allowed the adult protection team at county hospital to develop a team with the district attorney, city prosecutors, civil attorneys, geriatric doctors, police and sheriff’s detectives, advocates, adult protective services workers and my own mental health team. We meet every week to identify ways the team can act directly and indirectly to protect vulnerable older adults from criminal abuse. I also meet with the Coroner/ DA led elder death review team and I am the foreperson of a federal investigative grand jury. I tell you all this to prepare for this message. There is no federal law addressing elder abuse. There isn’t federal policy about the specific crimes committed against older adults. As the baby boom generation begins to age into seniority, I think it would behoove us to support long-needed policies on this type of crime. Why would that be needed?
I hear FBI agents, and ICE agents, and NCIS and Postal Inspectors and Forest Service and Internal Revenue testify and give evidence. I speak with City Police and County Sheriffs. They say that there is very specific training on child abuse but not elder abuse. Maybe the fraud investigators or homicide detectives have a smattering of experience that deals with specialty crimes against the older adult.
There needs to be policy on a national level. We need to make this an issue in next year’s elections. See www.ncea.aoa.gov for current legislation.
On an immediate level, I notice how many of the cases that reach prosecution begin with anonymous tips and reports. If you are afraid someone is being hurt, tell someone. If nothing is wrong, at least they were checked out. If something is wrong, you may have saved a life. If you are a mandated reporter, you may have saved your job. ELDER ABUSE HOT LINE (877) 4-R-SENIORS (877) 477-3646

Sleep hygiene: Not the practice of keeping clean but the behaviors we do to try to get to, and to stay, asleep. There is a belief that the older we get, the less sleep we need. The evidence is otherwise. The need for sleep remains about eight hours from young adulthood throughout life. It may be harder to get sleep the older we get because of health problems and other factors. The need for the full night’s sleep is evident in studies that show heart, mood and safety risks associated with less than adequate snooze time. Weight control and immune function have recently been linked to adequate sleep.
One truth is the “early bird” factor, the older we get, the more our circadian clock shifts backwards. Early to bed, early to rise was written by a guy who lived into his eighties at a time life expectancy was about 47 years. Teen-age brains don’t really turn on ‘til mid morning- getting up early to study didn’t help in high school.It is easiest to fall asleep when the body temperature is dropping. A hot shower or bath can keep you at fever temperature for hours. A tepid shower will help more with falling asleep. Remember that one of the ingredients in chocolate is caffeine. Even if there’s not a lot, a sensitive person will take a few hours to metabolize the stimulant. Avoid tea, coffee and soda after the sun goes down. Alcohol may make you feel drowsy but the chances of getting stimulated, restless and staying awake are just as good as going to sleep. Unless you drink enough to pass out in which case this column won’t help you one way or the other.
Darken the room, wear something or nothing, whichever is more comfortable. You might fall asleep in front of the TV but turn it off at bedtime. And have a bedtime! Consistency will help over time. Many people sleep better after sex. That would probably be with a long time partner, (no adventures if you want to rest).

I was at the flu shot event at Live Oak Park last Friday, seeing if my encouragement got anymore folks lined up for the jab. Since I last wrote about flu vaccine I saw a study in the New England Journal of Medicine citing a huge difference in death rates for older adults given flu shots. Up to 48% fewer hospitalizations! What I noticed in the long line in the morning, which quickly dropped to only about ten people waiting and a five minute visit over all, was this. Older people weren’t hurrying to get the shot and get out. They were hanging out with their friends, laughing and joking with the volunteers.
It reminded me of the value of laughter in health. It’s been long established that laughter will produce endorphins, circulate cerebro-spinal fluid and improve breathing. Most non-smokers never take a deep breath without a conscious decision to do so. Unless they’re laughing. The fluid around our brain and spinal cord has no pump, no heart to move it. Laughing does that.
“Words are worlds” and it’s no mistake that the opposite of gravity is levity. Laughter keeps you from the pull of the grave. So what if you have nothing to laugh about? What if you can’t remember the punch line of a joke? TV sure won’t do it. What causes a true belly laugh is the unexpected surprise in a conversation with someone else. Getting out with other people and taking an attitude of openness to the environment is the best thing you can do to find a laugh. You had to be there. Go to the movies or try a new restaurant. Find a group to join.
There is a new senior activity going on at Live Oak Park called Healthy Thursdays from 10 AM to Noon. It is free but they do ask for a reservation. The reason I bring it up is the November 29 topic- Laugh off That Turkey! That should levitate any of us. Call Mary @ 579-0461 to reserve.

One of those aging issues that is talked about is Parkinson’s Disease. PD happens to more men than women, more whites than African or Asian descended and increases with age. For those few unacquainted with the condition, a small part of the brain that regulates movement, called the substantia nigra, atrophies in a Parkinson patient’s brain. The usual symptoms are tremors or “pill rolling” sometimes starting on one side. Shuffling gait and stooped posture are a result of changes in balance. Eventually the person stops having control over starting and stopping motion. The face becomes mask like and the voice may soften or hush.
Recent studies link family members with dementia, especially Alzheimer’s type, to PD. They are very different diseases though. Memory changes with AD are different than the cognitive changes that may occur in late PD- attention rather than language tasks are measurably different. About 30% to 60% have memory changes after 70. Depression is also a concern. Swallowing can become an issue. It is easier to swallow something thick, like juice, than something thin, like water.
There is no cure for PD but there are a lot of treatment options. I read the other day that Parkinsonian rats get some relief from nicotine. There is a reduced incidence of PD with high cigarette and caffeine intake. The protection holds after stopping so there is no reason not to quit smoking, now! It is well established that some medications affect the ability to inhibit behavior; brain implants in PD patients have caused impulse disorders as well. This has led to compulsive gambling among other problems for some patients. Sinemet and other medications often give the person with Parkinson’s a cycle of time where their control is “on or “off.” At one hour they may be thrashing about quite a bit, later the control of movement is very good. In Belgium they have a rating scale to estimate driving safety for PD sufferers. There are a number of other conditions that can easily be confused with PD so be sure a qualified physician diagnoses and treats the symptoms. More info can be found at www.michealjfox.org.