Answers For Elders Radio Network

Sarah Chimbanga, Regional Director of Health and Wellness at Era Living, joins Suzanne. This segment covers the service plans and flexible licensing offered at Era Living. She's based at their University House Wallingford community. Their assessment process begins as part of the move-in process, as they gather sensitive & personal information for their assessment. While building a relationship of trust, they work to ensure the move is as smooth as possible. They talk about their service plans, exactly what care needs are supported at Era Living, and how they're reviewed and revised.

Flexible licensing is important because as residents might need further help, Era Living is able to provide additional care without the resident having to move to a different location, very important for couples, and provides a measure of comfort.

Sarah says, "We do the pre- move-in assessment, and from that we try to gather and gauge what are some of the services that we think a resident might need coming in. We also know that once you actually start to provide the care, once the residents actually start to receive the care, that there might be some tweaks that need to be made. So we usually do another assessment two weeks after moving in. And then following that, we do one every six months or whenever there's a change in condition."

The segment also talks about Assisted Living services versus Nursing Home Care. Assisted living provides assistance with activities of daily living. Two of their communities have memory care if they also need support for dementia, requiring a different set of skills.

Regarding how Era Living works with family, Sarah says, "We consider our families as part of the care team. A lot of families help support the residents with appointments, whether it's outside the community, they help with being the bridge or the advocate between the resident and their providers. So we found that it's really critical to include them any time we're discussing the care. So, for example, during the move-in process, a lot of families — if the resident chooses — do participate during that assessment. One of the things that we're trying to do is to say what can we as a community provide, how and what can the family also provide, or want to provide? And together, we kind of mesh those two: Here's what family is providing here is what our community is providing, and here's what the resident wants, because we always again try to keep the resident as the center of that."

There's more about Era Living at Answers for Elders and at eraliving.com. University House Wallingford is located at 4400 Stone Way N, Seattle, WA 98103-7485.

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On behalf of Humana, gold sponsor of the Vitality Revolution Podcast Series, Lori Hutson joins Suzanne. Lori is owner of LJ Hutson Insurance LLC in Washington state.

This segment focuses on emotional wellness: how do we nurture and be nurtured? It' how we can feel a general positive sense of well-being.

Lori says, "It's really managing our well-being, to take charge of that. We've been emotional beings for centuries, but it started coming to the forefront really in the 40s and 50s that psychologists and psychiatrists started thinking, oh, hey, wait a second, maybe we should become more aware of our emotional well-being. And then in the 70s, 80s, it really started ticking off. We are becoming a society that is more and more aware, and recognizing that this is really essential. It's not just love, or something just to think about. It's about our self talk and what we say out loud. Words do have a lot of meaning. We're talking about ourselves, or joking about ourselves. Or somebody pays you a compliment you say, oh, well, yeah. You really need to learn to accept that and love ourselves and I know it can be really difficult.

"But you might give gratitude. That's huge. If you think of one thing to be grateful for... the more we're in gratitude, the more our self-esteem flourishes. I have had a ritual for a long time where I get up in the morning and I write down five things that I'm grateful for, and it might be something so simple — we were talking offline about our pets, and it could be some funny little thing that my dog Ruby did, or our kids came over for Mother's Day and watching our little kids go through 500 water balloons. So tiny. But if we're just letting life float by, and we're not really recognizing those things, we're really missing an opportunity."

Contact Lori through her website LJ Hutson Insurance LLC.

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On behalf of Humana, gold sponsor of the Vitality Revolution Podcast Series, Lori Hutson joins Suzanne. Lori is owner of LJ Hutson Insurance LLC in Washington state. Regarding physical wellness, this segment focuses on the evolution of primary care. The overall landscape has changed with the advancement of tele-heath, being able to do visits from home.

Lori says, “If there's a silver lining in our industry with COVID, it forced people to use technology. Because when you're working with older folks, we're resistant to change, and I don't want to have to learn something new. And then, with the COVID restrictions, we had to. Tele-health has really added a new element to it. So you can be sitting in the comfort of your own home, set up the appointment, and have your primary care visit that way. I remember maybe 10 years ago being down with bronchitis, and I knew it was bronchitis. I had it once before. I called my doctor and they said no, we can't prescribe anything, because we have to see you. Well, my husband was working full time. I didn't want him to take time off. I couldn't drive, I was too sick. So by the time I felt well enough to stand up, I thought, well, I'm on the way to get better anyway. And so I think that, for some of those types of things, tele-health has really helped.

"I want to talk a little bit about our future. There are less and less primary care doctors available. What's happening is in the medical schools, the students now, for the most part, they're going for specialties, they want to be a cardiologist or an anesthesiologist. Primary care is suffering right now. And so I just think in another 10 years, what the heck is gonna happen, because there's not many students coming out, the older doctors are retiring. The insurance companies are really recognizing that. There's gotta be some innovative ways to help resolve some of these issues. One of the things that people are doing is this concierge doctor system, where you pay a monthly fee to have a primary care doctor on call. That could be $2- to $10,000 a year. If people can afford that, then they've got their doctor on call at any time.

Suzanne mentions now that One Medical has been purchased by Amazon, you can sign up through Amazon. Lori adds, "And the thing about One Medical is that is a national program. And so they have their One Medical, and then they have their One Medical Seniors. If you're looking at Amazon, and you see the One Medical, that has a monthly fee, but the One Medical Seniors does not have a monthly fee. That's embedded into your health care. That's one of the ways that some of the insurance companies are are trying to come up with some ways to help people. It's kind of a hybrid between having that concierge doctor on call all the time, and then having your normal primary care physician that you go in and you sit in the waiting room."

Contact Lori through her website LJ Hutson Insurance LLC.

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On behalf of Humana, gold sponsor of the Vitality Revolution Podcast Series, Lori Hutson joins Suzanne. Lori is owner of LJ Hutson Insurance LLC in Washington state.

This segment addresses dental health benefits available through Medicare Advantage programs. Dental health impacts our overall health and becomes more important as we age. Unaddressed oral infections can progress into your bloodstream and throughout your body to become something more serious. If you have to be treated for some condition, it's possible doctors will put off treating that if you have a dental problem, and have that treated first.

Lori says, “If you have original Medicare, you do have some coverage for a medical appointment, very limited. If you have something like a tumor in your mouth, or mouth cancer, things like that, that will be covered under original Medicare. I had an example, a member I was working with, she fell and she broke off all of her bottom teeth. Well, getting the teeth removed, that was a medical appointment, so that was covered under her medical, but the restoration wasn't covered. Then she needed a bridge, or implants, and that was not covered. So the Medicare Advantage plans, they will add in benefits, and dental is a huge issue right now, almost all of them now cover the basics. So they're gonna get cleanings, exams, X-rays, a couple of fillings. That's pretty standard, but then some of the plans — depending on your eligibility, depending on where you live, what's available for you — they will cover root canals, crowns, those types of things as well."

Contact Lori through her website LJ Hutson Insurance LLC.

See omnystudio.com/listener for privacy information.

On behalf of Humana, gold sponsor of the Vitality Revolution Podcast Series, Lori Hutson joins Suzanne. Lori is owner of LJ Hutson Insurance LLC in Washington state.

Suzanne says, "I am so thrilled to be able to launch this brand new program: "The Vitality Revolution." It's how to think about your wellness — Vitality, the eight foundational principles of wellness. And each month here on Answers for Elders, we're going to be focusing on two of the eight foundational principles. And this month will be on physical and emotional wellness."

Lori describes an experience with her family that brought her to her current career. "I grew up on a farm, and my dad was out in the field morning to night, and I do not remember one time growing up that he was ever sick. And it was amazing. The only time he ever went to the doctor was to get stitches because he cut himself on a piece of equipment or something like that. And so when he retired, he didn't go to the doctor. He went in because his leg was hurting, and he got diagnosed with cancer. By the time they found it, it was pancreatic cancer and gone into bone cancer. It was very serious at that point. And so they were telling me he doesn't have insurance. I was in my 30s, not even thinking about Medicare, that wasn't even on my radar. And so I opened up his wallet, there was a card in there and I said, yes, he does. He has it. He has Medicare. We'll come to find out it was only Medicare part A. He never took his Medicare part B and he was 81 years old. I got thrown into the Medicare maze, and his treatment's not being covered, and we had to sign up for Medicare. And I found a lady that helped me and I grabbed onto her like a lifeline. And so that's what really got me interested in doing what I'm doing."

Lori goes over the basics of what's covered under various Medicare plans, and also mentions services that a lot of people aren't aware are covered under Medicare. “I think a lot of people know your general test, that you can go in and have a flu shot, you can have pneumonia shot. Well, now the shingles vaccines and the DPAP, tetanus, those vaccines are all covered 100% now, that's a Medicare mandate. Those injections were pretty expensive for people. So I think that's one thing that people don't realize. I always recommend to people, because of what happened to my dad, go in and get those general tests done.

"Then there are things. There's more to diabetes management under Preventative that a lot of people don't realize. And then cardiovascular, there's some behavioral management on that. Depression screening, there's a stop smoking program through your Preventative. You've got colorectal cancer screenings. And now most of the plans are covering those at 100%, whether it's screening or it's diagnostic. The other thing I want to touch on is the wellness visit, because the advantage plans will cover a physical and a wellness visit, and there is a difference. So if you're going in and you have just original Medicare, you have a Welcome to Medicare physical, and that is a one-time thing. After that, Medicare doesn't cover your physical every year, but they cover a wellness exam. A wellness visit is your planning session — they'll ask when did you have your last colon screening? When did you have a bone density test? Have you had your vaccines? What's the plan for next year? Do you need the diabetes management program? Those types of things. That's your wellness visit. If you're going to your doctor and they're touching your body, that is a physical. They're looking in your ears, nose, all that kind of thing, that's a physical and the Advantage plans cover that 100% and then there's some blood work."

Contact Lori through her website LJ Hutson Insurance LLC.

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Parkinson’s expert Lianna Marie joins Suzanne to talk about how having a purpose affects your quality of life as a person with Parkinson’s. Also, she describes ways her mom found purpose and meaning on her Parkinson’s journey.

Lianna says, "In Parkinson's, life slows down and — good or bad, it slows down physically, everything slows down. So over time things will take longer to do. But in the same boat, many people who I've talked to that have been diagnosed with Parkinson's early on, they say it was a gift in the sense that it actually did make them slow down. And they may have had a busy life in their professional life and they were just busy, busy, busy, busy, busy. And this time — during their diagnosis and adjusting to their diagnosis, accepting their diagnosis — was a time for them to start thinking about: what is it that I want to get done in my life? Or why am I doing that particular occupation even? I mean, a lot of people thought about that during the pandemic. Having something that drives you every day to get up, and get going, is absolutely paramount. And especially for someone who has any kind of illness, terminal or chronic, science will tell you that that is what's keeping you alive. A very large percentage of Japanese people are living over 100. They did this study: what was the paramount reason why they were living past 100. Yes, health. And what they eat is very important and the exercise. But they pinpointed one area: ikigai. The word means, basically, that which makes life worth living. And having that ikigai, whatever you want to call it — your purpose, that one thing can lead to you living longer. Just think about the reverse when we don't have a reason to live, what happens? We give up."

For her mom, Lianna explains, "Having something every day that gave her purpose was really paramount, especially on those tough days when life is really challenging. Things we discovered, that for her to be part of a group where she was needed. So every time that that group met, they're like, "Oh Val, you're here, your job is such and such." And so she had a purpose right away. Iit was a singing group. She loved to sing, and she could still sing. So her job was to put the music together for each week. As simple as that. It really made a difference. I would say around year 15 of 30, I interviewed her reflecting upon all the things that have made a difference. And that was one of the things, where she said having a reason to be productive."

Listen to more of Lianna's podcasts on Answers for Elders and visit Lianna's website.

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Parkinson’s expert Lianna Marie, CEO of AllAboutParkinsons.com, joins Suzanne to talk about using art and creative expression to help her and her mother cope with Parkinson’s.

Lianna says, "There were times where she needed some outlets to deal with disappointments. One of the things is exercise, and how all of us can use that to work through things. But another is creativity, and I wanted to talk about that today, because it is an area that a lot of people with Parkinson's are starting to become aware of, and using their various creative outlets to help them cope through whatever emotions they may be going through: anxiety, sadness, fears of whatever. I would say that Carrie Fisher quote of, 'turn your broken heart into art,' I've loved forever, ever since I heard it, was just managing that, that sense of loss and turning it into something.

Parkinson's patients "start medication, and it's to supplement the dopamine that's they're losing. So most will get on some form of dopamine and, people started noticing, 'hey, I'm getting a lot more creative. Like, I didn't used to be a painter and now magically, I can paint this beautiful masterpiece.' And there are some actual studies going on right now saying this extra dopamine is pointing to higher creativity levels. I've seen people doing welding projects to creating clocks, to photography, to painting, things that they wouldn't otherwise have done before. And it's really quite fascinating. So there's one, that it can be their medication that's helping them become that way. But we are also directing people to find that creative outlet to help them just as a way to turn broken heart into art.

"There's a really neat website, Parkinson's Art. Folks around the world are contributing to this site, and you can take a look at it because it speaks for itself. You'll see. It's a way that you can share your work, whatever you're doing. Some folks are creating videos, others all different kinds of art. But it's just another way to showcase it, and within the community of people with Parkinson's, so it's a neat little thing.

My mom's creative outlet is gardening. And as she got a little bit more challenged physically, she had someone help her. She had a rock garden on a slope and various flowers, and she had a vision of what she wanted that to look like. I am not the person who does the gardening. It's not on my resume — we learned the hard way because my mom would say do this, do this, do this. And I'd be like mom, I'm just gonna do it this way. And she's like, no, that's not how the garden works. So we got a friend to help us out, all that to say mom's creativity was channeled through this other woman who was brilliant at it. So that was one way we adapted, in terms of mom having this wanting to get this creativity out with regards to her flowers, and how they were going to be arranged, and having someone to help her with that. And for others, it's all different kinds of creativity. For me, putting together books, writing, helping other people — that was channeling my disappointment or sadness if you will over my mom.

Lianna adds, "Google Arts and Culture is really neat. I discovered this during the pandemic. I'm trying to think of folks that maybe are less ambulatory. It's a site where you can visit a lot of museums virtually. Not every museum offers this, but it's kind of a neat way to get inspired if you're unable to visit in person, for example. Because I find being immersed in things like that helps my creativity, gets me inspired.

"Another thing that it's kind of similar is this concept called 'forest bathing.' It's Japanese, and I won't even try to butcher the name [shinrin-yoku]. Forest bathing, all it is, is to try to get you to immerse yourself in all your senses whilst going into a forest. It sounds very basic. But again, it's to get in tune, it's somewhat the mindfulness. It's to get in tune with the sounds, if there are any in the forest, with the feels, with the smells, with everything. And again, it's to get you centered. And oftentimes people find being connected to nature is also a way that inspires their creativity.

And photography, lots of photography. My mom ended up being inspired by nature, and picked up photography after her Parkinson's diagnosis, and was really into that. So just an idea, there's always avenues. I feel like everybody has a creativity within themselves of some kind. The question is how is that gonna come out, and getting involved with groups is also another way. I find that with various support groups, Parkinson groups, can help too, because I think people like that are in the same boat as you are very often encouraging you to be involved, or to let your creativity flourish, and they're like, that's really good, you should continue on with that, you know."

Listen to more of Lianna's podcasts on Answers for Elders and visit Lianna's website.

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Parkinson’s expert Lianna Marie, CEO of AllAboutParkinsons.com,

joins Suzanne to talk about coming to terms with a chronic illness such as Parkinson's that changes your life.

“I just want to talk today about some of the disappointments, practical or emotional, that mom went through, and things that we were able to do to help her through those, or that she did herself. As we went through, we tried to replace — let's say you, you lose this thing, but let's try to gain another thing over here. If you are a very active person, and now you can't be, that's a huge disappointment. In my mom's case, she was a knitter. If there was competition, knitting, my mom would have been a competitor because she was just the best to put things together. But if you can imagine those fine motor skills slowly deteriorating, and then her not being able to do that anymore. What could we replace that hobby with? And there was piano, then it became singing, and then if it wasn't singing, it was outdoors working on her rock garden. And so it was always trying to shift, going, "OK, we can't do this. OK. What else can we do then keep focusing on, what can we do?" It wasn't saying that we weren't sad about it. It was just saying, well, we're not dead yet. So let's find another thing, and personally, that's how I had to do it for care partnering, and certainly most of my disappointments would have come when mom had dementia. That piece being taken away, mom's ability to have that relationship with me. How did I deal with that? Not very well at the beginning."

Lianna adds, "An unexpected disappointment was in the way that some of my mom's close friends reacted to her diagnosis, and not all in a positive way that you might expect. I will give them the benefit of the doubt, that I think back when that happened, there wasn't a lot of as much information out there about Parkinson's, and there was a stigma. This concept that they had in their mind was that mom was now gonna be this frail invalid that couldn't do anything. And so they changed their view about her. That was a huge letdown for my mom. Of all the things I might have anticipated, that was not one of them. We cut bait from a couple of these friends, because they were definitely not supportive.

"With my sister, when she was diagnosed with terminal cancer, that stress can exacerbate any disease process. The idea that my sister get rid of all the negative things, negative people, it sounds very cut-throat. But in my sister's case, she really had to do that very quickly because, unlike my mom, she had a lot less time. It's a similar case to my mom where these people were not helpful. It was really just saying, "ok, you know what, you're in or you're out, you're on this boat with me or you're not. Mom did have a lot really — as she would call them — gems in her life. Friends that were just fabulous, and family members that really supported her on her journey. And I would just say to everyone that that is a really key. It's basic, but really, life is too short."

Suzanne pointed out having unrealistic expectations of family and friends. "I'm really disappointed in my brother because he didn't come for Thanksgiving," and it could be my mom or dad's last Thanksgiving dinner. And so I had all this in my head, 'He should have been there, and why didn't he do this? And we were all there, and we couldn't have him in the pictures' and all these things. And then we get angry. But the brother says, 'I just had to work.' That is simplistic view, but the whole point is, pay attention to your expectations."

Lianna adds, "That's a great point. Not the easiest thing, because you're like, "But I don't get it. I don't get why they can't do this. It's just so easy." Well, it may be easy for you, but maybe not so easy for them, for whatever reason, and it's not giving them an excuse. It's just saying, hey, we're not all built the same. I am guilty of wagging my finger at one of my siblings and It was just me: my expectation was a little higher than what they were doing.

"I cannot say enough that, in general, just it's always good to keep positive, find your best tribe, your support group, your support people, stick around them and focus on those folks instead of keeping your focus on the one negative."

Listen to more of Lianna's podcasts on Answers for Elders and visit Lianna's website.

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Parkinson’s expert Lianna Marie, CEO of AllAboutParkinsons.com, joins Suzanne to talk about coming to terms with a chronic illness such as Parkinson's that changes your life.

One thing that comes with it is a stigma, so there's a level of embarrassment. Some might see someone with a tremor or stooped posture, or walking wobbly, all Parkinson's symptoms, but someone might assume they're inebriated. Or how they're speaking slower, or quieter, and people assume they might have an intellectual disability. Those are common ones, and because of that you can imagine someone with Parkinson's living with it, and they see their challenges being beaconed, and they'd be embarrassed about potential attention. It's a personal vulnerability, of feeling exposed, and it comes with feelings of uncertainty.

Lianna says, "With my mom, when she was a little embarrassed about that tremor, I guess a lot of times it would be out in public when we'd go out for dinner, for example. She didn't like the attention when she'd walk into the restaurant. Again, not that everybody was staring, but in her mind, everybody was staring. Cramped spaces often would make her slow down or abruptly stop, which many people with Parkinson's experience. And so when that would happen, instantly, she's like, "Oh, my gosh, all eyes are on me." Those were some specific things that could happen, or would happen with her. It did take some time for her first of all to just accept it, relax about it... And they may not even be thinking that. In her mind, everybody's looking at me. I guess it's not unlike a lot of people who have disabilities don't want the attention. Like, hey, I'm in a wheelchair, so what?"

One bit of advice she provides is humor. "You need to say, 'You know what? I'm owning my life here. I have Parkinson's, but Parkinson's doesn't have me.' It's easier said than done, taking yourself a little less seriously, because at the beginning there's so much about you, and you're so focused now on that tremor, the slurred speech, or whatever it is that is attracting people. Easier said than done. Especially at the beginning, it takes time. I'm not saying that this is an easy task, but in general, the more we can take things a little less seriously, add a little humor and playfulness. And Michael J. Fox is great at making jokes about himself, like when he falls or, or something like that.

Regarding how to set guidelines or boundaries with their friends, Lianna says, "It is awkward, right? I try to talk to people with Parkinson's and ask them, what is your preference? You have this thing, and it's helpful when a person with Parkinson's does say, 'hey, I'm still the same person and yeah, look at my hand over here. Yeah, it's got a mind of its own and it's gonna move around while we're talking. But yeah, you know what, I'm still me, let's just still have this conversation. But if you need to ask me questions about what's going on with my body...' It's an individual thing because some people are very private, and they're like, 'I don't want to talk to you about my medical diagnosis.' Let them lead the conversation when it comes to Parkinson's. And and otherwise, just be there, and offer to say, "hey," because a true friend does that, they don't bail on you and just say, 'oh my gosh, you've got a disease, and now I'm out of here.' Just be that friend still. Try not to make it all about Parkinson's."

Listen to more of Lianna's podcasts on Answers for Elders and visit Lianna's website.

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Director for Education and Culture for Koelsch Communities Benjamin Surmi joins Suzanne to talk about where to find resources to help reinvent ourselves.

Benjamin says, "Do not discount the community center in your city, do not discount any kind of lifelong learning institute at a local university. In most metro areas some really cool stuff is happening that is empowering seniors to continue learning... You may also find faith communities in your local area that are doing some really innovative work that is just fascinating to you. As well as many senior living communities like ours offer educational events that connect you to resources and people that you might not have thought about."

He adds, "There's also some really cool stuff happening at a national level, with new organizations that are doing some fun stuff. Cogenerate just got started recently. And what they do is they bring the generations together to solve pressing issues. They have a program that brings retired physicians out of retirement and puts them in the most challenging places in America to help. They have a program that pays seniors who want to do something special with their encore years, actually pay them, and mentor them in doing it.

"Maturias and Seniors@Work match seniors who want to contribute in the business world with organizations that want their talent. CatchaFire matches non-profits that want to grow with a senior who'll give them a one-hour call to share their knowledge base in a particular field. A one-hour call can change the trajectory of a non-profit, and some seniors have decades of experience. Bloom provides a 3-week coaching program to identify what a senior's encore years would look like. Get Set Up is a group of hundreds of members where older adults teach other older adults in all sorts of subjects.

Even in our 50s, we all should be thinking about what matters to us, what connections matter, and what we want to do when we're 90. If we're making decisions based on finances or comfort, we're not making choices that will allow us to keep doing the things that matter to us.

Koelsch has senior living locations in eight states: Arizona, California, Colorado, Idaho, Illinois, Montana, Texas, and Washington. Listen to our podcast conversation with Aaron Koelsch, the CEO of Koelsch Communities. Learn more about Koelsch Communities at their website or call (360) 867-1900. Hear more of their podcasts at Answers for Elders.

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