Sleep, Perchance to Dream

Can you imagine how hot a topic sleep is these days? Do a Google search on “sleep.” Today there are 148,000,000 entries. Just for the word “sleep. Respectable magazines, newspapers, news shows, medical journals, poems, stories, millions of words are being written about sleep and how much we, Americans, are deprived of this essential part of life.

Recent studies reveal that the lack of sleep is at epidemic proportions, costing over $150 billion in lost worker productivity and high levels of stress. Over 50% of Americans report having trouble sleeping one or more nights a week and nearly 75% say they are sleep deprived. Lack of sleep can drive you mad. It can make you sick, literally.

Without question now, science declares that lack of sleep leads to several health problems: fatigue, obesity, diabetes, depression, elevated blood pressure. Secondary issues emerge as a result of fatigue. Accident reports often cite the cause of the accident as sleep related. And more than half of those driving trucks across this country, for example, report sleep deprivation and fatigue. The medical profession walks a fine line between preparing doctors to stay focused on patients regardless of competing human demands and ensuring safety of patients by allowing interns, for example, enough sleep.

There are so many angles on this topic, we’ll need many blogs to unravel them all. This week I’m taken with research by Dr. Sara Mednick (photo at right), a research scientist at the Salk Institute for Biological Studies in La Jolla, CA. She received her PhD in psychology from Harvard University. Her book, Take a Nap: Change Your Life. Dr. Mednick’s research is focused on understanding how napping can improve human performance. She introduces her Nap Wheel and discusses optimum napping time and how it’s possible to design a nap to inspire creativity one day, and the next day design one to help us with memory enhancement. I listened to her today on the radio while doing errands. She described how important it is to consider a nap during the day, no longer than 20 minutes, and in some cases only 10 or 15 minutes. She noted how caffeinated our culture is and argues that napping provides a natural way to refresh, enhance performance and otherwise improve the quality of life and work.

The discussion centered on the stigma of “sleeping on the job.” Our culture values high levels of productivity and the idea that people are sleeping during their work day is a notion difficult to accept. Dr. Mednick reminded listeners, however, that people sleep at work every day, most without their bosses ever noticing. And the calls into the program confirmed her assertion. Several callers said they and their colleagues have a notification system at play to ensure no one gets caught napping on the job.

Maybe it’s because I was raised in New England, but I only nap if I’m sick. I’m sure all those reminders about idle hands and devils definitely influenced my choices about saving sleep for night time. That’s not to say I don’t occasionally experience sleepiness during the afternoon. So, is it natural to nap? Dr. Mednick says yes. When subjects are tested in environments without clues about time of day, they almost always fall into natural rhythms, including a nap at some point midway through periods of being awake.

Of particular interest to me is why daytime sleep is very different from night sleep. It’s important not to nap long, Dr. Mednick says. Sticking to something between 10 and 30 minutes is ideal. Otherwise, your body might mistake the nap for night sleep and you’ll wake up groggy and slow.

So, what about you? Do you take a nap regularly? If so, tell us more about your routines. If not, why not? We’ll talk more about sleep in these pages. We hope you will join the conversation.

Mobility and Medicare: A Practical Guide, Part III

Earlier this month we wrote about Medicare and eligibility requirements for coverage of power vehicles, walkers and canes. This week we tackle manual wheelchairs. It’s a bit complex, so pour yourself some lemonade and focus.

Manual wheelchairs fall under a category called “capped rental.” What this means is that Medicare sets up a “rent to buy” approach when covering manual wheelchairs. The assumption is that the need for a manual wheelchair may be temporary, or the need might not be clear after just a short period of time. Rather than covering the purchase outright, Medicare sets up this approach to ensure that only the need is covered. Here’s how it works.

You still need all the same essentials as previously mentioned:

• A written and signed order from your physician with a clear diagnosis and length of need. This must be in the dealer/provider’s hand before you can get the wheelchair.
• The physician must have a written evaluation in his/her medical charts of your condition that supports the need for a manual wheelchair. (You might recall from our earlier discussions that this need is primarily to address MRADLs, mobility-related activities of daily living in your home. The fact that you would like to get out and shop once in a while is not a covered reason!)
• Signed forms and copies of your Medicare card to leave with us, the dealer/provider of the wheelchair, so we can do the complimentary billing for you. The paperwork also gives us permission to work directly with the physician to ensure all materials are provided. We help assess the likelihood of whether your claim will be covered or not.
  

So, let’s assume you have the written and signed order and show up at Capabilities. You also have your Medicare card. (If you have the Power of Attorney or are the spouse of the individual needing the wheelchair, you have the authority to sign. We still need the Medicare card to copy for our records.) The prescription (written order) makes it clear, for example, that you must have an 18” standard manual wheelchair for an indefinite period of time in order to perform MRADLs in your home.

You must fill out Medicare paperwork and a “capped rental” agreement that sets a monthly fee for the use of the wheelchair. You pay Capabilities directly for that monthly fee since our arrangement with Medicare is such that we collect payment up front. If Medicare accepts your claim, you will be reimbursed for the covered amount (generally about $57). You will not be reimbursed for any additional fees that the dealer/provider charges. If we believe your claim is not viable, or if paperwork is incomplete, we will explain to you up front that we have reservations about the claim. You can choose to continue by signing an authorization that allows us to continue, called an ABN (Advance Beneficiary Notification) that acknowledges that you know Medicare may deny the claim and not reimburse you. You can also decide not to proceed at this point. The choice is yours.

If Medicare covers your claim, you will continue renting the wheelchair on a month-by-month basis for up to 13 months (or sooner if the rental fees equal the covered cost of the wheelchair in less time). At the end of that period, you effectively own the wheelchair.
If, however, your need for the wheelchair ends sooner than that period, you must return it and Medicare will cease reimbursement.

We should briefly mention other types of manual wheelchairs. In some cases, a patient might not have the upper body strength to self-propel a standard wheelchair. This is one of the evaluation points that the physician must be clear about in his/her notes. If there is insufficient strength for a standard wheelchair, but the physician determines there is enough strength for a lightweight manual wheelchair, the order must clearly state this to be the case, along with the diagnosis and length of need. In some cases, upper body strength is so weak, a power wheelchair is the only solution. We have already discussed coverage of this item in previous blogs.

We are also asked about whether Medicare covers transport wheelchairs. These are the chairs with smaller wheels and must be pushed by someone else. As you might guess, there are very particular, and rare, circumstances when a transport chair will be covered. Coverage requires evidence of a caregiver in the home, for example. Reimbursement is minimal and many dealer/providers do not offer a billing option for this type of wheelchair. As always, it is best to discuss your needs fully with your physician.

Clear as mud, right? We can help you sort your way through the morass of paperwork. What we cannot do is hustle the process along. You should expect the process to take several months before you receive a clear response to the eligibility of the claim. We get calls all the time from customers who wonder where their reimbursement is. Sometimes we can easily track down the claim with Medicare, other times it takes an army. Claims often get rejected several times due to insufficient information from physicians, old codes, or details that are not completely clear to the administrators processing the claims. If there is a problem, we work on solving it as speedily as possible if it something we can troubleshoot. If, in fact, the physician has not provided the appropriate diagnosis or proof of evaluation of your situation, there is little we can do to remedy that situation. Believe me, when Medicare accepts the claim, you will know about the same time we know.

As we have mentioned previously, the way to appreciate Medicare is to view it through the same lens you would use for any insurance coverage. There are covered benefits and there are many situations not covered. To imagine Medicare as an entitlement or to rely solely on it for all your medical needs is to invite heartache and disappointment. When the circumstances match the eligibility requirements, Medicare is an important tool in managing your healthcare. Always feel free to ask us questions at Capabilities where we have experience working with Medicare.

Please post your questions and comments and we’ll get back to you right away.

Why Not Fix It Before It Breaks?!

This week's guest blog comes from Dr. Michael Merzenich, Chief Science Officer of Posit Science and the Brain Fitness program that we are so excited about. For more than three decades, Dr. Merzenich has been a leading pioneer in brain plasticity research. He is the Francis A. Sooy Professor at the Keck Center for Integrative Neurosciences at UCSF. Dr. Merzenich is a member of the National Academy of Sciences. He is the recipient of numerous awards and prizes, including the Ipsen Prize, Zülch Prize of the Max-Planck Institute, Thomas Alva Edison Patent Award and Purkinje Medal. Dr. Merzenich has published more than 200 articles, including many in leading peer-reviewed journals, such as Science and Nature. His work is also often covered in the popular press, including the New York Times, the Wall Street Journal, Time and Newsweek. He has appeared on Sixty Minutes II, CBS Evening News and Good Morning America. In the late 1980s, Dr. Merzenich was on the team that invented the cochlear implant, now distributed by market leader Advanced Bionics.

An article in the New York Times published about two weeks ago mirrored by an article in the AARP Bulletin bumptiously extolled the wonderful energies in the pharmaceutical industry directed toward medical strategies for more effectively treating or ‘curing’ Alzheimers Disease. The NYT science writer focused on Wyeth Laboratories, because they are putting down most of their chips on an AD play. Both articles pointed out, quite correctly, that there is a tremendous effort and substantial treasure being expended in this drug development arena, and that almost every major manufacturer is working hard to crack this nut. The marginally effective drugs now available for AD patients have been highly profitable for their producers; new proprietary drugs that could actually arrest the AD pathology should be of extraordinarily high value. It would appear to be highly likely that several such drugs shall soon come down the pike.
A drug that can effectively arrest the progression of AD pathology would be a great boon to just about everyone I can think of — possibly excepting all of those folks who own and run long-term care facilities! Sorry, guys and gals, but it would be a sweet thing, indeed, to see YOUR business take a big hit!

At the same time, I have three alternative reactions to this rosy picture.
First, why, exactly, would anyone want to have their pathology arrested in the first stages of AD?! That’s just a little bit like being sent to Limbo! An individual is not exactly in tip-top mental shape when their doctor dubs them with the AD label. On the other hand, to the extent to which drugs do not merely arrest decline, but also help enable a brain plasticity-driven rejuvenation in this population, they really could be the kind of ‘wonder drug’ described in these articles.

Second, when we have intensively trained individuals who are in a pre-AD medical status, their cognitive decline appears be arrested — and, in fact, significant functional rejuvenation is recorded. These practical studies combined with a growing number of animal studies indicate that brain fitness exercises can, by themselves, prophylactically sustain brain health over an extended epoch. Training (like that provided by Posit Science’s Brain Fitness Program) has at least five significant advantages over drugs.

• It holds the promise of prophylactically preventing the onset of the changes that themselves lead to AD onset. (A precaution: Studies measuring these prophylactic values of training are in progress. They are not yet definitively determined.)
  
• Training is organic. By its nature, undesired side effects just don’t come into play.
  
• Training strategies are inexpensive — in total, a small fraction of the cost of any proprietary AD-targeted drug.
• Training can provide a basis for continuous patient performance monitoring (through automated self-assessments and an Internet communication like) that helps ASSURE a 'safe' patient status across future time.
  
• Finally, if you’re as far down the path of decline as an early-AD patient, you an already make very good use of brain fitness exercises, in any event!

Third, waiting for that drug that’s going to save your bacon, like Waiting for Godot, can be frustrating! Maybe you won’t last long enough to reap its benefits! My advice: Don’t wait. Get thee to the Brain Fitness Center!

How In The World Do I….?

We get questions every day about stuff. We’ll highlight a question or two every week here and give you good information. If you have something to add to these discussions, please feel free to put in your two cents. You can post a comment or email us. So, here’s the kickoff for this series of everyday questions.

How Do I Determine the Correct Height for a Cane?

As with most things, your personal comfort should dictate how you respond to any circumstance. That said, there are some basic rules of thumb about mobility tools. To determine the correct height for a cane, your wrist should bend slightly. Your forearm should be at about a 30 degree angle while standing straight. Feeling steady and comfortable are essential to safety while using a cane. There are many options today that make the fitting of a cane a piece of cake. An adjustable cane, for example. Folding adjustable canes are great for travel.

A common follow up question about canes has to do with what side to hold the cane on. This should not be so difficult, but it is. Conventional wisdom, along with many professionals, suggest using the cane on the side with the injury, weakness or disability. Others argue that holding the cane on the stronger side adds further strength to shift and bear the weight more fully. Once again, experiment until you feel steady and comfortable. There are many types of canes, so be sure to try them out before you select.

As always, we invite you to comment. Or ask your own question and we’ll address in future blogs.

One Scientist’s Mission to Turn Gerontology on Its Head

The latest issue of AARP magazine (July/August 2007) features a story about a scientist and his mission to prove that aging is bad for you. What? Aubrey de Grey (at right), computer scientist turned biologist, says that aging kills 100,000 people a day. He is turning the world of gerontology upside down. “I’ve been outraged that gerontologists were being so mealy-mouthed,” he explains, “wanting to understand aging but not doing anything about it.”

He says that aging is nothing more than a systems failure due in part to engineering. He has developed a seven step strategy which he calls SENS (Strategies for Engineered Negligible Senescience). He outlines seven essential causes of aging (almost all are types of cellular damage) and offers ways to repair them. Eliminating these types of cellular damage would extend life to 125 years and beyond in bodies that would be essentially disease-free, he insists.

Many scientists take issue with de Grey’s claim that aging is as treatable as many other diseases, although his mission to shake up an arm of science – gerontology – that has not seen many radical developments in years is definitely working. Most agree, however, including de Grey that funding and policy have been in short supply when it comes to the topic of aging. AARP points out that the National Institutes of Health allocated 0.1% of its $28 billion in funding to aging-related research and medicine. Some scientists recommend upping that amount to at least $3 billion.

There do seem to be many more individuals who are living beyond 100. These folks can be great case studies while alive by examining not only social conditions, but their DNA. The AARP article reminds us, too, of cultural differences, such as the phenomenon of how many French people maintain their weight and proper cholesterol levels in spite of their diet of bread and cheese. It’s the wine, they say. Or is it? Research on mice is in progress, testing theories of longevity first on those critters.

Of course, there are important ramifications of extending life well beyond 100. Just think how many more retirees to workers there would be then? And what about environmental impacts? Would we lose something essential if we lived to 125? What do you think? Post your comments or email us your blog on aging.

from Dr. Marion's Blog

We mentioned last week how great it was to meet Dr. Marion Somers and have her at the store. Here is an excerpt from her tour blog entry from her trip to Denver, dated June 12, 2007. You can read more of Dr. Marion’s blogs as she wends her way across this country, meeting people who are thinking about how to reinvent the aging process, at drmarion.com. We wish to thank our colleague, Jeff Rubin, Executive Director of the Alliance for Holistic Aging (AHA), who invited Dr. Marion to stop by Denver on her tour. He told her about Capabilities and the ways our two organizations interact and helped us all connect. Thanks, Jeff. You can learn more about AHA by visiting holisticaging.org.

Denver is properly known as the mile high city. It rests at the foot of the Rocky Mountains, which show off their snow-covered peaks in the near distance. I was invited to be the keynote speaker at the Mayor’s 16th annual “Walk into Health” which was held at the beautiful Denver Botanical Gardens.

After the presentations, many of the attendees came over to learn more about what caregiver resources were available and to discuss how the elderly have contributed to society. Another interesting topic revolved around the importance of delegating as a caregiver. Many people also wanted to talk about my trip, and that made me feel good.

Later on, I spoke to a group of professional caregivers in a round table setting. I was inspired by what they had to share. They spoke from the heart about their caregiving experience and in no time at all, these strangers were not strangers anymore. Having the experience of being a caregiver in common allows people to know each other in a very connected way. Caregiving can be a challenging process, but it’s always made easier by sharing and talking about it with someone who understands.

Just outside Denver, I also visited a store called Capabilities that’s dedicated to people with special needs, especially the elderly. It’s fully equipped with a variety of practical and sometimes whimsical items, and the store is bright, airy, and welcoming. The two owners are informed, helpful, and always searching for new materials and solutions that can help those in need. They are frontier women breaking ground in today’s modern world.

In fact, many people whom I’ve met on this trip are ground breakers in their own way. They are improving on the path that has been laid before them. The elderly walk and create the snow-covered path before us. We can walk the same path they’ve made for us, or we can make a totally new trail and leave our own imprints for others to follow, all the way up and over the snow-capped mountains that stand watch over this amazing city.

Are You a Stubborn Parent?

“I suppose so,” Margaret admitted. “Well, it depends on who you ask,” shouted Doug, a bit hard of hearing. Vera said, “Absolutely not!” And Kay just grinned slyly.

This tiny sampling speaks worlds about how we think about ourselves in relationship to a question like the one I ask, “Are you a stubborn parent?” These folks, all over 75, spark still with energy and commitment to living life as fully as possible. They are a little taken aback at first, then chat on about their impressions of aging, the parts they like, the parts they hate. “It’s hard being told what to do by your kids,” Doug goes on to say. “I know they are just trying to help out and are worried. I do love that part. And maybe I don’t always use the best judgment about some things now. But, I still feel 35 inside.” Kay picks up on that part. “A couple of years ago I caught a glimpse of myself in a storefront window and nearly fell over. Even though I look at myself in the mirror every day, there was something about seeing myself in that window that shocked me. My shoulders were droopy, my hair was so white. I thought, ‘I’m old!’ But, you know what,” she continued,” I still feel spry.”

So, it got me thinking about this idea of stubborn parents. I can’t say I did not think this thought myself on occasion as my mother aged and ignored many of my suggestions. I see it, too, in the store as Boomers and others come with their parents or grandparents, excited to find so many useful tools. Sometimes these outings go great. Other times…Well, let’s just say they won’t be remember by either party as one of the more beautiful moments of sharing. In all cases, though, intentions are pure and the love is evident.

How it is that qualities such as boldness and independence can become viewed as “stubbornness” as someone grows older? How can the fact that mom or dad made it all those years without our help fade so fast when signs of aging appear? Make no mistake. We all know there are many real changes that aging brings that we ourselves cannot see clearly, especially at the start of decline. The desire to stay independent is in our bones; we push our way into it right from the start of life. Who hasn’t remarked on how quickly a baby senses freedom when those first steps occur? It just gets stronger from there. No wonder we fight all the harder as time works its ways on muscles, eyes and ears, and sometimes brains.

However, the care giving instinct in humans is almost as fierce, I find. We fuss around the safety of those our children as they take those first steps, as they learn to cross the street, as they get their drivers’ licenses. And, as it turns out, we bring that same instinct to our loved ones when we see signs of their aging. The big difference, though, with levels of tenderness and patience come as the baby becomes a toddler becomes a kid becomes a teenager. “How many times have I asked you…?” So, it is with our parents. At first, our hearts are tender and patient as dad begins to realize it’s not just someone mumbling, but in fact he is losing his hearing. Or, when mom trips and falls the first time, second time, third time. When the signs get more pronounced and the parent seems not to notice or care, patience wears thin. Or worse, when mom or day say it’s just not so! It is then that those around them begin to get edgy and say things like, “You are such a stubborn parent!”

What can be done? Honestly, probably nothing will permanently alter this dynamic between humans. You can only change yourself. If you’re the one giving the care, maybe it is time to refocus on the tenderness, and help find the practical solutions that enable your parent to stay as independent as possible through these changes. There are so many tools and products out now that everyone can use, like jar openers, reachers, and grab bars. Maybe if you buy one for you, too, mom won’t mind using it. Ask her questions about the changes you are seeing and find out whether they are the same ones she notices. Surely, she knows she can’t do things the way she used to. It might be a relief for her to admit them as long as she knows you won’t get carried away with constraining her freedom in unreasonable ways. Unreasonable to her, that is.

And dad, maybe you could listen through the ears of love and caring, ask questions about what kinds of changes your son is seeing that cause him to mention that it’s time to make those changes in the house every time he sees you. He’s probably not just saying that to annoy you. He truly is concerned about something. Find out what it is and have a conversation about it.

If you’ve both just been through too much and it’s unlikely either party will change, it might be time to call in a third party. Professional care managers, therapists and other health-care professionals can often bring sanity to a battle of the wits. They can describe situations objectively, lay out the options, and help channel fear and worry, often the culprits when communication breaks down.

Take this mini survey yourself. Ask a few loved ones in your life, “Are you a stubborn parent?” Make some notes and post them here (changing names, of course, to protect the innocent!). Ask yourself this question if you are a parent, regardless of how old you are or what ages your children are. You know somewhere there is someone who thinks you are stubborn. “I’m just fiercely independent!” John says. “And I plan on staying that way as long as I can!”

Now that’s spunk! Tell us your experiences with stubbornness!

Skip to My Lou!

I take a morning walk quite faithfully. It’s a wonderful way to start the day, in spite of the fact that I usually grumble about getting up so early to fit it in. I see all the regulars in the park and we nod our heads, say “Good Morning,” and keep on moving. There are rituals of all kinds going on around me. Dogs and owners running, training each other, and feeling healthy, for example. Ducks, babies and in-line skaters. And the annual spring planting of flower beds! The staff at the park really love this and all the “oohs” and “aahs” they get from us, the faithful, grateful to see the brown heaps give way to spectacular colors.

Friday was just like any other day last week. I noticed, though, that as I made my way up the street leading to my house, nearly finished my own ritual for another morning, I was overcome with memories of being about 9. Whether it was a fragrance from a nearby flowering bush or the way the wind blew my hair, I cannot say. All I know is that I was suddenly possessed by the idea of skipping! I pictured myself skipping home from school, book bag dragging, sweater tied around my waist. I felt tenderness for that little girl that was me. The array of memories just in that moment filled me to the brim.

I wondered how one might describe skipping to someone who had never done it before. I thought about the hopping action and tried to figure out the words to describe that other thing the feet do. This exercise kept me entertained for a couple of blocks. Wikipedia surely has a definition, I thought. (I have since looked it up there: “The hippity hoppity gait (human) that comes naturally to children,” it reads.)

And then, something else happened. I became obsessed with wondering whether I could still skip. I still had a few blocks to go and there was someone walking in front of me. I decided not to try it right then just in case I fell on my face. She would come rushing and trying to be nice and I would be dying from embarrassment as I told her I was only trying to skip.

I could not get the idea out of my head, though. As soon as we turned at different corners, and within site of my house, I started skipping. Big smile! Victory! Phew! It’s amazing how grateful I felt about it. I decided I will use skipping as one gauge of my own aging process.

Can you skip? Young, middle, or old, let us know with your comment to this blog.

A Word of Advice... Build Relationships

It is our pleasure this week to introduce Joni Seivert as our guest blogger. Joni specializes in home care options, products, professionals, and placement in assisted living and nursing homes. Joni founded Connections Unlimited, LLC, a preferred provider network of the best in the greater Denver Metro area., to help families look at the needs of their loved ones as they age and help them through the maze of possible options and choices. We work with Joni a lot as we interact with customers who need not only products, but help figuring out what to do next when illness, injury or the impact of the aging process calls upon families to provide care for the people they love and nurture. Because Joni has spent the last 18 years connecting professionals of all kinds in the Metro area, families have choice and the relief of knowing there is a whole network to support them.

I often suggest to people that if they could do as much planning for their retirement and old age as they do for a wedding or a vacation, they could have a much better quality of life! Look at it as an adventure and explore your options. Anything is possible today. One of the statistics that gets people’s attention is to mention that you could spend more time caring for your aging parents than you did raising your kids! It’s 19.5 years for your helping your aging parents and 18.3 years for your kids. That is if they do graduate and leave home and never have to move back in.
Begin to wrap your arms around the amount of time we could be dealing with the many options in services, products, professionals and long term care facilities that exist in our community. As we learn from helping our parents, we can get inspired for ourselves. Boomers will age and the sooner you get excited and embrace it the better your life can be. We are living on the average twenty years longer due to better health habits and medical technology and I’m here to help you by asking the right questions. Then, I give you your options so you and your family can make an educated decision.

We have a term called “aging in place” that refers to where we want to be to do our aging and that can accommodate our needs as we do so. Most people want to do that at home and we can keep people in their homes 3-5 years longer today, if they have the resources to pay for it because of the wonderful in-home care provider companies and retail products and adaptive equipment that help us upgrade our home to the safest environment possible.

One of the important themes that I ask you to consider is to imagine yourself developing a relationship with your providers. You want to make sure that you get the right match in caregivers and that you can get the same two scheduled consistently and grow your hours as your needs increase. Everyone is concerned about having strangers come into their homes so make sure you make a list of all the questions in your mind.

Remember you could be working with them for a long time.

• Find those who are in the business for the right reason.
• Have a conversation with them.
• Ask to hear their story of how they got into this business.
• Find out how long they have been in business.
• Be sure that they have a track record and can provide good references.
• Check on how much they value and strive to provide good customer service.
• Make sure they deliver what they say they will-consistently.
• At a competitive price.
• Who are they affiliated with? Have they earned the merit of belonging to any associations, networks, or the BBB?

You can reach Joni at jonisconnections.com and at 303-232-3359 for a free telephone consultation. Thanks Joni!

Featured Product: ArmRx Cast and Wound Covers

You know you’ve done it. You drag out the plastic bag to cover that cast or bandage and tie a rubber band or zip tie around it. You just cannot stand one more day of not taking a shower or bath, even though you are not supposed to get that injury wet while it’s healing.

Oops, the bag leaks! You jump out of the shower, soap still everywhere, worried you have just set yourself back. You find it hard to believe there is not something out there you can use. Why didn’t that doctor tell you about ArmRx.

ArmRx products are patented innovative lightweight sleeves and/or leggings that provide totally effective and watertight protection. ArmRx protectors are suitable for use anywhere there is bath water. You can see a great demo by visiting armrx.com if you have any doubts about its effectiveness.

Dr. Marion Comes to Denver

We had the pleasure this past week of meeting Dr. Marion Somers, experienced geriatrician and care manager,who has provided care for more than 2,000 elderly clients while she owned and operated a thriving Geriatric Care Management practice. Dr. Marion is an accomplished lecturer who has presented the following seminars: “Care of an Aging Parent;” “Caring for the Caretaker;” “Counseling Skills;” “Dying, Death, and Bereavement;” “Geriatrics; Retirement Planning;” and “Stress Management for the Elderly.”

It is now Dr. Marion's goal to help caregivers everywhere by providing valuable insights and information. Her book, Elder Care Made Easier, helps caregivers maneuver through everything from the basics to some of the thornier decisions caregivers must make for their loved ones. It’s the kind of book you can pick up and choose a relevant chapter right in the middle, if it suits you. And it is easy to make your way through. While there is plenty of science and experience behind it, you don’t have to wade through all that to find practical information about caring for your aging parents or relatives.

A few weeks ago, Dr. Marion set out on a cross-country tour, visiting bookstores, recreation centers, assisted living centers, retirement communities, churches, libraries, bringing her message of caring and community building. She bought a 1960 something Greyhound bus that had been outfitted as a camper. She fixed it up, got a couple of great guys to do the driving and filming, and off she went. She’s making her way East from California. Denver and Capabilities were on the way! We felt honored to host her and show her our store. She interviewed us as part of the documentary she is making as she wends her way across America.

One of the most impressive qualities of Dr. Marion is her curiosity. Although she has spent a career understanding the aging process, she looks at each circumstance and each person with freshness and patience. It’s as if she is uncovering something new all the time. We were delighted, for example, to show her some things she had not yet discovered. Like the unique Xtenex Knoty Boy shoe laces that have knots to adjust a perfect fit at each set of eyelets. It’s an elastic lace that gives you complete ease slipping your shoes on and off. In fact, she bought a couple of pairs for the two excellent men who are her road crew on this great journey of hers. And our wonderful Chillow, especially great as the thermometer goes up this summer. Dr. Marion likes how we blend traditional products with a host of new and unique items that anyone can use.

We’ll be writing more about Dr. Marion. She has agreed to write a guest blog for us while on the road. Stay tuned. In the meantime you can visit her website at drmarion.com. Sign up for her newsletter and read about her discoveries on the road. She is truly inspirational.

Be Conscious of Your Energy

It is my pleasure this week to introduce you to Ingrid Elfver, a personal discovery author, artist, and teacher. As founder of Simply Authentic™, Ingrid helps others empower their unique and powerful Authentic Self. Originally from Sweden, Ingrid began her inspirational ministry after a life-transforming awakening. Simply Authentic™ is based on 16 years of research and life-transforming change with thousands of clients in the USA and abroad: celebrities, executives, entrepreneurs, spiritual seekers, parents, teenagers and children. Ingrid says, “Our personal energy is powerful, affecting not only our Self but also everyone around us. Everything we experience in our being--every thought, feeling, and belief--is visible to others.” Please note in Events that Ingrid will conduct one of her Simply Healing classes on June 19, free of charge. You can find more information at simplyauthentic.com.

Our personal energy is powerful, affecting not only our Self but also everyone around us. Everything we experience in our being--every thought, feeling, and belief--is visible to others. Positive or negative, every emotion that passes through our conscious or unconscious being is seen by (and has a powerful effect on) others.

Although we might sometimes like to think differently, there is nothing we can hide from anyone. In one way or another--sometimes subtle, sometimes profound--we all sense and feel each other. So it is important that we become more aware of, and learn to better manage, our negative energy: Stress, fear, and worry, as well as other limiting thoughts, feelings, and beliefs.

Be more conscious of your energy. Use the Simple Tools for Authentic Living in this weekly column (Exercises, Mantra, Affirmation, Visualization, Meditation, Prayer, and Message from Source) to clear and refocus your energy. Have a positive, empowering effect upon your Self and everyone you encounter. Remember each moment that you are a positive, sparkling light Source. Ever and always, a brilliant being... Beaming out into the Universe.

Exercises:

• Know your Self. Are you feeling tension or stress, having negative thoughts, or otherwise limiting your Self? Pay attention to what you are feeling. Then ask your Self why you are feeling it. Take some deep relaxing breaths.
• Center your Self. You now know that you are feeling, you know what you are feeling, and you are breathing deeply. Reconnect with your Authentic Self. Align with your power, peace, and wholeness. Breathe out, releasing your tension. Breathe in the center of your Self: Your love and your light.
• Be conscious. Know that you can slow down and breathe your Self back in. Visualize your energy as loving, compassionate, and present. Decide to be a positive and conscious energy, in your life and in other people's lives.
  

Mantra:

• "I am conscious and embrace my positive energy."

Affirmations:

• "I am aware and conscious."
• "I know my Self."
• "I am positive energy."
  

Visualization:

• Visualize your Self at peace with every part of your Self. See your personal energy being conscious and positive. Say to your Self, "I am the light". See and embrace your true and pure Authentic Self. Visualize your Self letting go of any negative thoughts, feelings, and behavior. Visualize your Self right now, consciously replacing them with positive, empowering, light-filled energy. Feel strong and at peace with your Authentic Self. You are conscious, filled with enthusiasm and positivity, every moment of this day.

Meditation:

• Close your eyes. Take deep breaths. Inhale through your nose and exhale through your mouth. Turn your focus inward, reconnecting your Self with Source. Feel the love and light coming from Source, entering your body, heart, soul, spirit, and mind. Now breathe that positive and infinite flow into your Self, and know that this is your true energy. Feel this positive light healing and replacing all negativity. Take a deep breath and accept your Self, as a conscious and positive energy. Breathe in your light. Feel your Self emanating brilliant, loving, infinite light. You are shining with positive, compassionate energy, from the inside out.

Interfaith Prayer

• My Source... Guide me to my Authentic Self... Show me how to stay connected with my true and empowered energy... Positive infinity... Help me choose what is good for me... And always be positive and conscious about what I need and feel... So I can always reconnect with my Authentic Self... And know that I truly am One with You... Ever and always... Blissed be...

Message from Source

• “Choose to be a positive and empowered energy and force. You are my reflection."

Saturday At The Air Show

Pam and I attended the open house for the newly named Rocky Mountain Airport (formerly Jefferson County Airport) over the weekend. In addition to all the usual open house festivities, the organizers hosted a big air show with vintage planes and a few surprises. We brought scooters and back cushions and all things comfortable. Pilots work hard, especially those that fly those smaller planes. One of the big hits was the Travel John. One pilot said those things have saved him many an unnecessary stop! It was a different venue for us and we liked it. Among the surprises were some impressive machines flown overhead courtesy of the U.S. Air Force.

At one point, Pam looked towards the horizon and noted something unusual approaching. As thin as paper, this object emerged as the Stealth Bomber. What a unique airplane! It’s huge, bat-like, and almost silent. Its wafer thinness ensures its ability to approach without warning. We followed its daring moves as it flew low, soared upward and looped its way around the airport. How long had it been since we stared with necks bent upward, thrilled and curious!

The afternoon continued to awe us as more military marvels flew above us. The F-16 roared in as if propelled by a giant slingshot. It shot straight up into the heavens, disappearing for a second, looping around and around, upside down, inside out. A pilot nearby explained just what would be happening physically for that pilot were he not securely wrapped in a G-suit and helmet. Not a pretty sight to imagine!

Technology surprises and amazes us all the time. No sooner did this spectacle subside, leaving everyone in a chatting mood, than up drives someone to our canopy in a honey colored scooter. It looked familiar…and then, so did the man driving it, as did his family around him. All smiles, he asked how he looked in this riding machine. He had come into the store a while back, finally ready to get mobile again. He said, “I cannot imagine how I ever managed without this beauty!” His family agreed. “We would not be here together today,” they said. “He would have been home in front of the TV.” He was out and about in ways he had not been in ages. He even got to his grandson’s graduation recently.

So, in the same day, we experienced the jaw-dropping site of Air Force planes that are changing the way war and peace happen and the heart-warming scene of how this electric scooter that we picked out for our inventory months ago is changing the way one man and his family live. How lucky can you get!

Please tell us about a technology that is changing your life. We love your stories and are happy to put them on our website.

Words We Don’t Use At Capabilities

Recently, someone made the comment after reading one of our brochures how interesting it was that we don’t speak about people of a certain age as “seniors,” “elderly,” or the “geriatric” crowd. Others have remarked that we also don’t often speak about Capabilities as being a “medical equipment” store, or a place with “durable medical equipment.” Why is that? While there is nothing inherently wrong with those words, or others that describe physical disabilities or the aging process, we are in the process of reinventing not only the language to describe all this, but the ways to manage the changes that occur with time and circumstance.

As we planned Capabilities, we envisioned something very different. We imagined a place with something for everyone, regardless of age and ability, a place where we did not categorize people into age groups or disabilities. We pictured rather a place where all would feel welcomed and where we would offer a broad array of products for health, mobility and comfort. We also did a bit of our own research and found that many people don’t enjoy being called “seniors,” even though they accept fully their own aging process. Our own mothers, for example, shrieked at anyone calling them “elderly.” Maybe it’s that our culture stopped appreciating and honoring “elders” at some point. Other cultures, for example, hold the older generation in a place of high esteem, respecting the wisdom that comes from many years. Our culture, it seems, devalues us as we grow older. So, common words that should not be so full of potentially negative meaning, such as “senior,” “elder,” “older adult” have taken on too much symbolism that makes many of us feel not so comfortable.

We thought a lot about this as we put our plans for Capabilities together. We wanted to create a space where everyone would feel welcomed. As a result, when it came time to print brochures and describe Capabilities, we did not feel comfortable using some of the common words you will find others using. In fact, our name alone – Capabilities – came from the passion we felt about focusing on the abilities we all have, regardless of circumstance. Our tag line, “Be Unlimited,” came from the inspiration we both got from having known so many diverse people, some of whom have overcome great challenges.

We meet business people all the time who are struggling with what to call their services, having originally chose to put the word, “senior,” in their business name. AARP, for example, just uses the acronym. They no longer describe the organization as the American Association of Retired Persons. They also have changed their newsletter and magazine, featuring people of all ages, including those still in their 40s. Other organizations, too, are experiencing push back as people resist some of the labels that have grown up around them. As Baby Boomers age (one wonders if those of us in this generation will always be called “Boomers?”), it is a certainty that they do not want to have the stereotypes that have emerged about growing old foisted upon them. (Who does, we ask?) So, teams of marketers and others are sitting around conference tables dreaming up commercials like the ones you are seeing now. You know, like the one with Dennis Hopper, holding the dictionary, reading the definition of “retirement.” He flings that dictionary and says that this generation is reinventing retirement. And so it is that we are reinventing the type of place where you can shop for all kinds of products that bring relief, comfort and independence. We call them “lifestyle” products to accommodate all kinds of ways our lives change. You’ll feel the difference whether you come into our store, or go online.

It’s clearly time to create some new words, don’t you think? What are some of your thoughts about how we refer to the various generations, and whether we can invent new ways to talk about aging? How do we create ways to soften the edges between the generations, in reality and in the language we use? It’s unlikely we will all live together as generations did in earlier times and in other cultures. So, what will be our equivalent of blending families and generations?

Please tell us your thoughts.

Take a Bath Again!

We hear all the time how hard it is for many to give up taking a bath. We also know that the bathroom becomes one of the most dangerous places in the house. My own mother years ago had the frightening experience one day of not being able to get out of the tub. She worked and worked at it, finally managing to get up and out without falling. It changed her life! She was finally convinced that it was time to stop taking baths. Begrudgingly, she agreed to a shower bench, shower hose attachment, bathmats and grab bars. But it was never the same for her again. She loved soaking in a long, luxurious bath at the end of the day. We did not know then about some of the incredible options that exist…And, I doubt that some of them existed, at least in the form they do today.

We’ve written before about the Safety Bath. If you are planning a remodel, that is still the way to go to ensure a safe and wonderful bathing experience. We are also impressed with the Tub Lift, a comfy chair with a battery pack that sits inside the tub, rises to the edge to allow for easy transfer onto the seat, and gently lowers you into the water. It will take you to within a couple of inches of the bottom of the tub. It’s a dream! The chair even reclines a bit, allowing you even more comfort while you bathe. You can get a few weeks’ worth of bathing on a single charge of the battery pack. The cover is machine washable and easy to manage. We highly endorse this product and so do a number of our customers.

Complete the safety experience of bathing by adding a Tub Bar, designed especially to clamp onto the edge of the tub. Its sturdy design and easy to grab handle provide exactly the help that many need when entering or exiting the tub or tub lift.

If you have experiences overcoming the challenges of taking a bath, please tell us. Post a comment below.

Mobility and Medicare: A Practical Guide, Part II

Last week we discussed the guidelines Medicare uses when considering coverage for electric scooters and power wheelchairs. This week, we will look at the process for purchasing canes and walkers through Medicare.

As you saw last time with the series of questions the physician must respond to when charting your case, Medicare will cover the equipment needed for mobility related aids for daily livings (MRADLs). If a cane or walker will respond to the need, Medicare will cover the appropriate one and not a manual wheelchair or power operated vehicle.

The critical documentation needed before you can obtain a cane or walker is a written, dated and signed order by the physician. You must present that order to the provider of the cane or walker, although a faxed copy will often suffice. The key is that this order must be dated BEFORE the purchase. At Capabilities, we do complimentary billing for Medicare, so you will typically pay for your cane or walker up front and we will submit the billing to Medicare.

As with the case of power operated vehicles, however, the physician’s records must reflect why you are in need of a mobility device. A clear diagnosis must be included in this documentation. Our billing office is in contact with the physician’s office to complete the documentation required before the claim can be submitted.

Be advised that Medicare has reimbursable limits for each item. In the case of a cane, for example, that reimbursement is $21.07. This amount usually represents only a percentage of the true price of a cane. A quad cane (with a four-pronged base) has a slightly higher allowable of $47.55. (Remember that these are current figures and are subject to change.)

Walkers are slightly more complex as there are many varieties. Medicare is most likely to cover a standard walker, or a standard walker with wheels, typically 3-inch or 5-inch wheels. There are rare circumstances when Medicare will cover a “rolling walker,” the type with four wheels, a seat and hand brakes. If your physician believes this is the only type of walker that will work with your condition, s/he will have to be very specific about the condition and why this is the only option. As with canes, the order must be written, dated and signed by your physician. We need the order in hand before we can sell you the piece of equipment.

It’s important to keep in mind that once Medicare covers one piece of mobility equipment, there must be a significant change in condition for Medicare to approve another claim for more mobility equipment. There are, of course, conditions whose symptoms progress dramatically, and in these cases the diagnosis and medical chart will clearly reveal the need.

Check future blogs for more information about Medicare.

Please email us or post your questions or comments regarding Medicare in general or if you have a specific question.

Count Me In

You see from our Breaking News headline today that we have great news about Capabilities. It was an incredible honor to represent Pam and our store in Atlanta at this huge Count Me In, Make Mine a Million $ Business event. The finalists, chosen from an applicant pool of 200, presented in front of several hundred women business owners, including judges from the Small Business Administration and other corporations. I am so proud of all that we have accomplished since our Grand Opening in September 2005.
Of course, we could not have done it, nor can we continue to be successful without all of you as our wonderful customers and supporters.

I want to tell you a bit more about the Count Me In organization. It’s the leading not-for-profit provider of online business loans and resources for women to grow their micro businesses into million dollar enterprises. Inspired by the passion of Nell Merlino, CEO, the organization sponsors other programs. Nell launched the Make Mine a Million $ Business program in 2005 with founding partner, OPEN from American Express, with the intent to help a million women entrepreneurs grow their businesses to $1 million or more within the next three years. In 2006 several leading corporations joined the effort: AIG, Cisco Systems, FedEx, Intuit and QVC.

There are over 10 million women-owned businesses fueling the American economy, employing almost 13 million people and generating $1.9 trillion in sales. The number of majority women-owned firms grows at around two times the rate of all businesses. However, when compared with men who start their own businesses, women’s businesses do not typically grow as fast or as large. While there are many factors, business experts site finding mentors and role models, and securing enough capital are the two major road blocks.

Nell Merlino, a successful entrepreneur in her own right and long-time advocate of women entrepreneurs, decided it was time to put a plan in place to help women break through to the next level. This is the third year Make Mine a Million $ Business has awarded women entrepreneurs mentoring, marketing and financial packages. The results are already impressive. For example, eight of the 2006 awardees already have reached the million dollar mark within one year of receiving their award package.

Much has been written over the years about the similarities and differences between men and women entrepreneurs. Our economy and society need plenty of both to ensure a constant supply of employment opportunities, innovation, and imagination. With organizations such as Count Me In, women entrepreneurs can get the leg up they often need to access resources and information so valuable to the process of building a business.

We are grateful and proud to be part of this growing number of women. We are committed, too, to continuing and strengthening our line up of products and services that support your needs and wish lists. Please email us with your ideas as we are always eager for your feedback.

Many thanks, too, to the National Association of Women Business Owners (NAWBO) for its support of the Make Mine a Million $ Business. As incoming Vice President of the Denver Chapter, I am honored to be surrounded locally with so many supportive and smart women entrepreneurs.