As we age, thoughts often turn to how to afford medical care, buy food and pay bills. It will therefore come as a relief that Government Aid is available, namely in four specific categories; Nutrition, Housing, Medical and Employment. We take a look below how the different programmes work and who qualifies. 

Food & Nutrition

Keeping a good nutritional diet has a range of health benefits, and the country has a number of government aid programs to help seniors eat well. The food and nutrition programs available between states can vary widely. All aim to make healthy nutritious food more accessible for the elderly population. State specific programs will be advertised by the local Area Agency on Aging.

• Senior Farmers’ Market Nutrition Program (SFMNP) – provides low-income seniors with access to locally grown fruits, vegetables, honey and herbs. State agency contacts can be found here. 

• Commodity Supplemental Food Program (CSFP) –  works to improve the health of low-income seniors aged 60 and above by supplementing diets with nutritious foods. All fifty states, the District of Columbia, Puerto Rico, and five Indian Tribal Organizations participate in this scheme. 

• Nutrition Assistance Program (SNAP) – provides nutrition benefits to supplement the food budget of in-need families to purchase healthy food and move towards self-sufficiency. State specific contacts can be found here. 

• Food Distribution Program on Indian Reservations (FDPIR) – provides food to income-eligible households living on Indian reservations and to Native American households residing in designated areas near reservations or in Oklahoma.

• The Emergency Food Assistance Program (TEFAP) – federal aid program that helps supplement the diets of low-income Americans, providing them with emergency food assistance at no cost.

• FNS Disaster Assistance – state, local, and voluntary organizations provide nutrition assistance to those most affected by a disaster or emergency. 

Housing

For low income seniors, there is a range of government aid available to help with the cost of mortgages, utilities, taxes and other expenses. Costs that were manageable when working full time can suddenly become overwhelming for retired seniors with a reduced income. Seniors should check with their state agency to identify which programs are available and the specific eligibility criteria. 

• Housing Choice Voucher Program – Income assessed criteria. Helps seniors, families  and people with disabilities afford housing in the private market.

• Supportive Housing for the Elderly Program – subsidizes independent living-type apartments for seniors that offer services like transportation, cooking and cleaning.

• HUD Information for Senior Citizens – The U.S. Department of Housing and Urban Development resources for seniors on all aspects of housing.

• Eldercare Locator – Provides information to help seniors understand housing choices and make informed decisions.

• Indian Housing’s Office of Native American Programs (ONAP) – Information on safe and affordable housing is available to Native American families.

• Housing Improvement Program – a home repair, renovation, replacement and new housing grant program administered by the Bureau of Indian Affairs (BIA) and federally-recognized Indian tribes for eligible Indians.

• VA Geriatrics and Extended Care – programs helping older veterans with a wide range of housing needs.

• Single Family Housing Repair Loans & Grants – provides income based grants to elderly homeowners to remove health and safety hazards.

• Weatherization Assistance Program (WAP) – Income assessed program led by the U.S. Department of Energy to help reduce energy bills and increase efficiency of insulation, heating and cooling systems. 

• Low Income Household Water Assistance Program (LIHWAP) – provides funds to assist low-income households with water and wastewater bills. 

Medical & Healthcare

Paying for medical care can put a big strain on finances. The two main government aid programs that assist with medical costs are Medicare and Medicaid, which both cater to seniors. Although similar, there are differences and it’s possible to hold dual health plans with both Medicaid and Medicare. Individual states may also offer aid towards prescription drugs programs. Further information can be found on the state specific aging guides. 

• Medicare – The federal health care program for people aged 65 years and above. Consists of three parts Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance) and Medicare Part D (prescription drug coverage).

• Medicare Savings Programs – state help to assist with paying Medicare premiums. Medicare Savings Programs may also pay Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) deductibles, co-insurance, and co-payments if certain criteria are met.

• Medicaid – provides healthcare coverage for low-income adults. It is administered by states, according to federal requirements and jointly funded by states and the federal government.

• VA Health Care – Veteran cover providing regular checkups with primary care providers and specialist appointments (e.g. cardiologists, gynecologists, and mental health providers). Services such as home health and geriatric care, medical equipment, prosthetics, and prescriptions may also be available.

Employment 

As retirement age beckons, people find themselves looking for jobs to fit around their lifestyle or hobbies. There are a number of government aid programs to help seniors earn money or learn new skills. Social Security and SSI provide monthly payments for seniors who have met certain criteria. 

• American Job Center – Search tool to find workforce services in your neighborhood or across the country.

• Older Worker Program Finder – The U.S. Department of Labor Employment and Training Administration’s Senior Community Service Employment Program (SCSEP) subsidize part-time employment and training in community service positions to enable older workers to move to unsubsidized, private sector jobs.

• Senior Community Service Employment Program (SCSEP) – authorized by the Older Americans Act, the program provides training for low-income, unemployed seniors. A number of criteria are stated including; participants must be at least 55, unemployed, and have a family income of no more than 125% of the federal poverty level.

• Supplemental Security Income (SSI) Benefits – provides monthly payments to people 65 and older or those with disabilities who meet the financial limits. People who have worked long enough may also qualify to receive Social Security benefits as well as SSI.

• AmeriCorps – Volunteer service for Americans aged 55 and older who wish to serve their communities. 

• Social Security – provides a source of income when you retire or if you can’t work due to a disability. If you have worked and paid into Social Security, you become eligible for payments at age 62. 

• Federal Employees Retirement System (FERS) – a retirement plan that provides benefits from three different sources: a Basic Benefit Plan, Social Security and the Thrift Savings Plan (TSP).

• Credit for the Elderly or the Disabled – Tax credit for lower-income seniors which helps reduce the federal tax owed by eligible seniors. To understand if you qualify, take the short online interview here.

Miscellaneous 

Several other government supported programs are available for seniors: 

• Lifeline – federal program that lowers the monthly cost of either a phone or internet bill. To be eligible for the program, certain criteria must be met. 

• America the Beautiful – National Parks & Federal Recreational Lands Senior Pass – Provides entrance or access to Federal operated recreation sites across the country for seniors aged 62 years and above. 

• Home Equity Conversion Mortgage (HECM) – The only reverse mortgage insured by the U.S. Federal Government. This program enables people to withdraw a portion of their home’s equity to supplement their income. 

Conclusion

Managing finances can make the golden years stressful, but government aid programs can provide some relief. Programs and eligibility vary between states, so always check what is available in your area. Your local Area Agency on Aging is a great place to start. Contact information can be found in our State Resource Guides.

Yes, you read that right. Quick and easy. These are not words I usually associate with making risotto. I don’t make risotto often because it requires standing at the stove and stirring, stirring, stirring… while adding liquid a little at a time. Are you with me? It’s too much time, attention and effort.

Well, all that has changed! I am super excited to have found a new way to make risotto thanks to an old fashioned kitchen tool, the pressure cooker. Usually, I use a pressure cooker to do beans and grains and things that usually take a long time to cook. I got to thinking that risotto takes a long time… so what if I cooked it in the pressure cooker?

I decided to try it out making mushroom risotto. It turned out great! Here is this quick method to make a fabulous dinner that will impress your family and friends. And best of all, no standing over the stove stirring for 45 minutes. I was practically giddy over this discovery.

Mushroom Risotto Prepared in the Pressure Cooker

Ingredients

2 tbsp olive oil

½ onion, finely chopped

3 cloves garlic, finely minced

1 cup Arborio rice

4 cups chicken broth/stock

¾ cup of dried mixed mushrooms, roughly chopped or broken

Directions

Heat the oil in the pressure cooker pan and cook the chopped onions and minced garlic for about 3 minutes. Add the Arborio rice and stir to coat the rice. Then add all of the stock for the recipe at once along with the dried mushrooms.

Put the lid on the pan and bring it to full pressure for 5 minutes. Then do the quick release on the pressure, open the pan, stir for a minute, and – voila! – you have risotto. Sprinkle with salt and pepper and whatever fresh herbs (parsley, chives, etc.) as garnish, and you can serve it right up. I was in disbelief, but it really does work.

Butternut Squash and Dried Cranberry Risotto

I have a fabulous recipe for butternut squash and dried cranberry risotto that I love, but hardly ever make because it’s too much effort. But with the help of the pressure cooker I can make it in less than 15 minutes without stirring constantly.

Ingredients

1 ½ lb peeled and cubed butternut squash

½ Cup dried cranberries 2 tbsp olive oil

½ onion, finely chopped

3 cloves garlic, finely minced

1 cup Arborio rice

4 cups chicken broth/stock

½ cup crumbled gorgonzola cheese, 6-8 fresh sage leaves, ¼ cup chopped pecans and a pat of butter – for garnish

Directions

Steam the butternut squash until it’s softened but not mushy (15-20 minutes, depending on the size of your cubes). In the last 2 minutes of steaming, add cranberries just to soften them a little.

Meanwhile, heat the oil in the pressure cooker pan and cook the chopped onions and minced garlic for about 3 minutes. Add the Arborio rice and stir to coat the rice. Then add all of the stock for the recipe at once.

Put the lid on the pan and bring it to full pressure for 5 minutes. Then do the quick release on the pressure and open the pan.

Stir the squash and cranberries into the cooked rice. Put into serving bowls and top each with the garnishes.

There’s my favorite risotto recipe done in 15 minutes. No stirring for an hour! I hope you’re excited to try it. It has completely changed my experience of cooking risotto.

Now I get to have it for dinner much more often. As with all cooking, it’s an art. Let’s make it easier and more fun. Jump in and try something out that’s new. Let me know what you discover.

Do you cook risotto? How long does it take you? Have you found a neat workaround all the stirring? What do you think about using a pressure cooker to make risotto? Please share below!

For a long time, I’ve wondered why yoga teachers (even in their 80s or 90s) are so youthful and full of vigor and joy. Is it due to particular yoga poses, lifestyle, or something else?

I put this question, as inspiration for my new book, to 14 yoga teachers, all women, the youngest aged 66 and oldest 95.

The good news is that the beneficial practices they shared are available for everyone, not just yoga teachers.

Keep the Body Moving

The women all believe that many physical ailments of aging are simply due to lack of movement. While this might sound whimsical, studies prove that increased physical activity in older adults is associated with better health, less illness and higher levels of mental wellbeing and quality of life.

And this is where yoga can help. The smorgasbord of poses as well as stretching keep the joints mobile and body supple. Or as Vivian (aged 95) told me, “it’s ‘a case of use it or lose it’.”

I was amazed, when attending these teachers’ classes, at how easily they move from sitting (on the floor) to standing. The importance of maintaining this age-related ability is clear. For adults (aged 51–80) a reduction in floor to standing ability is associated with increased dependency and earlier death.

Again, yoga can assist with a range of poses that involve moving from floor to standing and vice versa. Depending on your physical limitations, it’s also possible to start by practicing in a chair (a form of yoga called chair yoga) and rising up and down.

Tania (aged 93) shared some instructions for Reverse Prayer Pose, her favorite posture. She recommends it for preventing kyphosis an age-related abnormal outward curvature of the spine.

She explains it like this:

Start by relaxing into the shoulders:

Then take your hands behind your back, fingers facing down to start, and press the fingertips together.

Then turn the hands upwards, and try to bring the palms together so that the little fingers press into the upper back.

This pose also keeps Tania’s wrists in tip-top condition, a necessity for playing her violin. Tania likens the body to a musical instrument – “you need to play it to keep it in good health.”

Take Time to Relax and Rejuvenate the Body and Mind

The teachers said they relish seeing their students leaving after class looking younger and more relaxed than when they arrived. Here the special ingredients are yogic breathing and relaxation practices that calm, refresh and revitalize the body.

Rest assured there are scientific reasons backing these claims. Let me explain. Whenever we face an actual (or perceived) fearful situation, the sympathetic nervous system is aroused. Straightaway, the body is pumped full of stress hormones causing flight, fight or freeze responses.

In fast-paced modern life, and especially during this time of Covid, our sympathetic nervous system is easily and often triggered. If this response becomes habitual, we become frazzled and feel worn out.

Studies show that yoga breathing (diaphragmatic breathing) and relaxation practices rebalance the body through switching on the calming parasympathetic nervous system. This bolsters serotonin and melatonin, wonderful hormones that do indeed make us feel and look happier and more relaxed.

Just as the women advise, yoga is a wonderful tool to nurture the body, allowing time to rest, rejuvenate and remedy the stresses of modern life.        

Maintain Positive Social Connections

Another benefit the women mentioned is that yoga creates a social community for students and teachers through facilitating positive connections (friendships) and a sense of communal belonging.

One of the teachers conducted a small survey asking her students what they liked best about classes. While she thought they might mention aspects of her teaching, the overwhelming response was about the social aspect.

The students loved catching up with each other and meeting for coffee after class. Even with classes online during Covid restrictions – and when loneliness may be common – this provides important social contact.

So, yoga facilitates community and positive social connections and emotions that are essential to health and wellbeing and happiness. The connection with others through yoga is a precious gift for students and teachers alike.

Are you already a fan of yoga? Or perhaps you’re put off trying yoga by glossy images of yogis performing advanced poses? Did you know there are many different styles and levels of yoga to choose from – not only ‘hot yoga’? How do you find the right teacher? Maybe you’re wondering how yoga is different from a gym or fitness work out? Please join the conversation and share your experiences.

Kristin Cavallari’s Yellow Dress at the Uncommon James Dallas Opening

Kristin Cavallari Instagram Fashion

This weekend marked the opening of Kristin Cavallari’s third Uncommon James location, this time in Dallas. Which thankfully, for us those of us who love the pieces, makes the store a bit more, well, common. Plus the event provided a Real Housewives of Dallas / Kristin crossover than we never knew we needed!

Since I was lucky enough to attend the Chicago opening, I did have a bit of fomo seeing these fab photos. But even if I wasn’t on the guest list (clearly they just have my new address ;-p), you’d better believe Kristin Cavallari’s yellow dress is now on my shopping list.

The Realest Housewife,

Big Blonde Hair

Click Here to Shop her Monse Dress

Click Here for Details on Kameron’s Look

Photo: @KameronWestcott

Originally posted at: Kristin Cavallari’s Yellow Dress at the Uncommon James Dallas Opening

For most people, the problem of bladder and bowel accidents, or incontinence, stems from loss of one or both integral parts of the system that must work together to empty the bladder and the rectum normally and without leakage or accidents: the muscles and the nerves.

Both the bladder and the rectum depend on a complex system of muscles that include sphincters and broad support muscles – what we call “the pelvic floor.” In both women and men, these muscles and nerves can be damaged or lose their integrity in several ways.

Common Causes of Incontinence

Age is statistically the number one contributor to loss of perfect nerve signaling and perfect muscle function. Some studies have estimated a 1% per year decline in the nerve signals to the pelvic floor. For some people, at some point, it becomes just enough of a deterioration to cause accidents.

Childbirth and pregnancy are the next reason these muscles and nerves are injured. Babies passing through the birth canal often tear the muscles in ways that do not show up as problematic until decades later. And during pregnancy and delivery, the important nerve transmission lines can get stretched and injured.

There are also numerous other conditions that contribute to the loss of proper bowel and bladder function and control. These include things like medications, radiation, surgery, cancer, and a broad range of health conditions that affect the nerves and muscles like myopathies, Parkinson’s, and diabetes.

For most of us, the problem starts small, with occasional leakage that slowly becomes occasional accidents, which soon become an every-day problem requiring pads and diapers and always carrying a change of clothes.

Addressing an Embarrassing Condition

Many people are embarrassed to talk about the problem to their doctor, and all too often, neither person realizes the problem can be solved. Sometimes people will bring up bladder leakage, but many times the problem of bowel leakage, or fecal incontinence, is just not discussed. So, let us take a closer look and consider specifically the problem of loss of perfect bowel control.

I will just say a quick word about how the problem of bowel leakage, which affects tens of millions of Americans, varies a great deal in its severity. The treatments also vary to match the severity of a person’s experience.

Some people have an annoying leakage only when they exercise, and they just find embarrassing spots on their underwear when doing laundry. But these individuals are not really bothered beyond that. Over time, however, the problem becomes worse, and many people find themselves having to wear pads, change undergarments often, or carry an extra set of underwear with them at all times.

Worst of all, some people start avoiding the great things that make life fun, like visiting with other people, exercising, and attending events. If it is more severe, the skin around the anal area can become seriously chafed and damaged, leading to fungal or bacterial infections.

Incontinence Solutions

The solutions start with some changes in diet, practicing home exercises, and the use of oral medications, ointment for the skin, and fiber supplements. The reason we start there is that loose consistency stools or diarrhea can be very hard for anyone to control.

With loose or liquid bowel consistency, lots of people will have little or no warning time to get to the bathroom. That same person, however, has plenty of warning time to get to the bathroom if the stools are firmer.

Diet

The strategy is to figure out what change in your diet you can undertake to make the stools firmer. For some people, it is identifying certain foods that cause diarrhea. A common example is dairy products for a person who does not realize they are lactose intolerant.

The first place to start is keeping a food journal for a couple of weeks and to write down the bowel movements of the day along with the consistency of the stools. Also note if there was an accident or leakage.

Fiber Supplements

Hardening the stools can sometimes occur with diet and sometimes by adding powdered fiber in the form of Citrucel or similar products. An important thing to remember here is that no two people are quite alike. I always advise my patients to consider this an experiment for a few weeks.

Medication

Next, we use common medications to firm up the stools: Imodium (loperamide) and Lomotil. These are often helpful and usually something to at least try for a few weeks.

Imodium binds to the receptor in the intestines that is a type of opioid receptor, slowing down the muscle contractions of the intestines. Some people experience dizziness or drowsiness, constipation, dry mouth, or fatigue.

Lomotil, on the other hand, has two active ingredients, and one of them is in a class of drugs called anticholinergics. It has a lot of side effects, especially in older people.

These include dry mouth, constipation, dry mucous membranes everywhere including dry eyes, and difficulty emptying the bladder. Worst of all, in older people these drugs cause confusion, memory loss and depression. We try to avoid these drugs in people over 60 years old for that reason.

Home Exercises

Exercises to strengthen the anal sphincters and pelvic floor have been shown to help somewhat. These can be done at home with Kegel exercises, plus some home exercises including squats and kneeling leg lifts. There are online tutorials, and specialized centers offer more formal training sessions with a therapist.

Biofeedback is a form of exercise in which additional information is gained based on monitoring the muscle activity to help the person better engage the pelvic floor and sphincter muscles. We try to encourage every patient to use these techniques and modalities, and our experience has been that they are helpful as an adjunct therapy but rarely work as a standalone treatment.

The Most Effective Treatment

Most people consult us after the first-tier methods of diet, fiber, anti-diarrheal medication, exercises have not worked. And that is where the good news is: because of better treatments, today we can almost always solve this problem.

The number one most effective treatment for fecal incontinence, and probably the best kept secret in all of medicine, is sacral nerve modulation (SNM). This therapy has been evolving for 25 or 30 years and was the brainchild of bioengineers who thought they could replicate the amazing success of cardiac pacemakers by making a “pacemaker” for the pelvic floor and sphincter muscles.

It turns out that they were 100% correct. The same idea of using a gentle current to restore the pelvic floor muscles and sphincters of the rectum and bladder causes nearly complete correction of the leakage and accidents in most people. This treatment is very much like the placement of a pacemaker, meaning that it is today a minor procedure performed with local anesthetic.

SNM is at least 90% successful in resolving bowel leakage in published, peer-reviewed studies. Medicare and virtually every insurance plan cover it, and the tiny device is placed under the skin in about 25 minutes with a single Band-aid. The newest devices have a battery life of a whopping 15 years.

What About Injected or Surgical Treatments?

Additional treatments include the use of a viscous filler material, or bulking agent, injected directly into the tissues of the anal sphincter. Several years ago, the FDA approved a specially designed dextranomer filler material called Solesta, and the treatment works moderately well.

The injection is performed in the office, and surprisingly, it is not painful. This treatment usually does not completely solve the problem all by itself, but it is a great adjunctive therapy. The substance is inert and not thought to cause any harm, but the body does eventually dissolve it over time, usually anywhere from 6 months to 5 years. There are rare, reported cases of infection, but it is a very benign therapy.

Lastly, there is reconstructive surgery. Amazingly, during my career, surgery has become rare in treating fecal incontinence because sacral nerve modulation works so well. Twenty years ago, it was not uncommon for a person to undergo a complex procedure to overlap and reconstruct the sphincter muscles, and then work on rehab for months. Today, that is very rarely necessary.

As you can imagine, this type of surgery is quite painful, and recovery can be very slow. Wound complications are common. So, it has been a tremendous improvement to have sacral nerve modulation today that has almost eliminated the need for this type of reconstructive surgery.

What if Nothing Works?

It must also be said that there are patients for whom no solution provides an answer and for whom the only good answer is to create a colostomy. This surgery brings the large intestine out to the skin of the abdominal wall and a pouch is worn under one’s clothes. Today, that is a last resort and rarely needed. Some cases of severe cancers and radiation still require a colostomy, but far fewer than in years past.

If bowel or bladder incontinence is an issue for you, it’s important to understand that you aren’t alone and that you have options beyond pads and diapers. I hope you’ll reach out to learn how your symptoms of incontinence can be resolved for good.

Have you silently suffered from one of the two types of incontinence? For how long have you held the issue to yourself? How many different treatments have you tried? What were the results? Which one was the most effective? Please share your story below.

Disclaimer: This article is not intended to provide medical advice. Please consult with your doctor to get specific medical advice for your situation.