Magnesium…really good benefits

This powerful nutrient can help with sleep quality and muscle and bone strength

Magnesium rich foods including leafy greens, beans, nuts, and avocado

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In general, foods containing dietary fiber provide magnesium, including dark leafy greens, legumes, nuts and whole grains.

The diets of the majority of Americans provide less than the recommended amounts of magnesium, according to the National Institutes of Health (NIH), with men older than 70 and teenage girls being the most likely to have low intakes. And deficiency isn’t to be taken lightly, as magnesium is needed for more than 300 biochemical reactions in the body, reports MedlinePlus, the National Library of Medicine’s website for consumer health information.

This mineral helps in maintaining function in our nerves and muscles and supports a healthy immune system. It also plays a role in keeping our heartbeat steady and bones strong. Current recommended daily requirements of magnesium for adults 51 and older is 420 milligrams for men and 320 milligrams for women.

There are not many obvious symptoms of low magnesium. For healthy people, the kidneys help retain magnesium by limiting the amount lost in urine. However, low intakes over a long period of time can lead to magnesium deficiency. “Symptoms of magnesium deficiency include loss of appetite, nausea, vomiting, fatigue and weakness. Extreme magnesium deficiency can cause numbness, tingling, muscle cramps, seizures, personality changes and an abnormal heart rhythm,” according to the NIH.

Older adults and magnesium

Roughly 70 to 80 percent of those older than 70 fail to meet their daily magnesium needs, according to Consumer Reports. Older adults have an increased risk for magnesium deficiency because they tend to consume fewer magnesium-rich foods than younger people. In addition, older adults’ bodies may absorb less of the mineral in what they eat, and their kidneys may excrete more of it through their urine.

While no one food has a huge amount of the mineral, you can try keeping magnesium-rich foods such as dark leafy greens, legumes, nuts and whole grains in regular rotation, Joan Salge Blake, clinical associate professor of nutrition at Boston University, told Consumer Reports.

In general, foods containing dietary fiber provide magnesium. Foods that provide at least 60 milligrams per serving include a half-cup of cooked spinach, an ounce of almonds, a half-cup of cooked black beans and a cup of cooked brown rice.

The connection between magnesium and sleep

Some small studies have found a link between low levels of magnesium and sleep difficulties, the New York Times reported.

“Magnesium deficiency has been associated with higher levels of stress, anxiety and difficulty relaxing, which are key ingredients to getting good sleep at night,” pulmonologist Raj Dasgupta told the Times. He is a professor of pulmonary and sleep medicine at the University of Southern California. Magnesium interacts with an important neurotransmitter that favors sleep, he said.

However, older people should take caution before considering magnesium supplements, which can have side effects, especially for people with kidney problems or other medical issues. Supplements can conflict with other medications and result in excess magnesium intake. It is best to talk with your doctor and try to include more magnesium-filled foods in your diet first.

Perfect for lowering Blood Pressure

It isn’t just about lowering your sodium intake

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Whole foods such as avocados, spinach, and whole potatoes are all good sources of potassium.

People 50 and over are frequently searching for ways to lower their blood pressure and focus on foods to eliminate, such as items high in salt. But can adding tasty items help, as well?

“Potassium can be a secret weapon when thinking of heart health, managing blood pressure and improving systems in the body,” nutritionist Jae Berman wrote for the Washington Post. Sodium and potassium, which are very similar chemically, join forces in a sodium-potassium pump in your body, which “moves sodium out of the cell and potassium into the cell,” Berman writes. This process is essential to cell function and energy production.

Unfortunately our diets are typically much higher in sodium than potassium, causing an imbalance in our system. According to the National Health and Nutrition Examination Survey, fewer than 2 percent of Americans achieve the recommended consumption of potassium, which is 4,700 mg per day. Yet the vast majority of us, over 90 percent, eat more than 2,300 mg of sodium per day, which is the top tolerable limit recommended by the Institute of Medicine. Just one teaspoon of table salt equals 2,400 mg of sodium, so it is easy to knock your system off balance.

Whole foods are the best sources of potassium, and avoiding packaged and processed foods is the best way to lower your sodium intake. Sources of potassium that Berman recommends include:

  • Avocado (Try swapping out salted butter with this natural treat in your next meal.)
  • Yogurt
  • Winter squash (acorn or butternut)
  • Spinach and other greens
  • Whole potatoes with the skin, such as yams and Idaho potatoes. (Just one sweet potato can give you 20 percent of your daily potassium needs, according to Health.gov.)
  • Salmon and sardines
  • Dried fruits such as apricots and prunes, and whole fruits such as bananas and grapefruit
  • Vegetables such as beets and broccoli
  • White beans, lima beans, black beans and other legumes

10 Free Services Medicare Provides

These preventive checkups help you maintain control of your healthcare

free medical test

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People who have had Medicare Part B for longer than 12 months are eligible for a free wellness exam.

En español | The phrase “there is no free lunch” certainly applies to Medicare. While the federal program pays the lion’s share of medical costs, beneficiaries can still spend thousands of dollars each year on premiums, deductibles, copays and other out-of-pocket expenses.

But the Affordable Care Act (ACA) expanded access to free preventive care, and that included some important Medicare services. Here’s a list of some examinations and screenings Medicare recipients now get for free.

  • A “Welcome to Medicare” preventive visit. This is available only in the first 12 months you are on Part B. It includes a review of your medical history, certain screenings, and shots, measurements of vital signs, a simple vision test, review of potential risk for depression, an offer to discuss advance directives and a written plan outlining which screenings, shots and other preventive services you need. This visit is covered one time.
  • Annual wellness visit. You’re eligible for this free exam if you’ve had Medicare Part B for longer than 12 months. The physician will review your medical history; update your list of providers and medications; measure your height, weight, blood pressure and other vital signs; and provide you with personalized health advice and treatment options.

Note: While this visit is free, the doctor may order other tests or procedures for which you might have a deductible or copay.

  • Mammogram. An annual screening mammogram is free. If you require a diagnostic mammogram, you’ll pay a 20 percent copay and the Part B deductible will apply.
  • Colonoscopy. A screening colonoscopy once every 24 months is free if you’re at high risk for colorectal cancer. If you aren’t at high risk, Medicare covers this test once every 10 years.
  • Diabetes screening. You’re eligible for two free screenings each year if you have a history of high blood pressure, abnormal cholesterol levels, are obese or have a history of high blood sugar levels. The screenings will also be free if two or more of these issues apply to you: You are over 65, are overweight or have a family history of diabetes, or you had diabetes when you were pregnant.
  • Prostate cancer screening. An annual PSA test is free. A digital rectal exam will cost you 20 percent of the Medicare-approved amount plus the doctor’s services related to the exam. The Part B deductible also applies.
  • Vaccines. Annual flu shots, vaccines to prevent pneumococcal infections such as pneumonia, and shots for hepatitis B (for those at high or medium risk) are covered free of charge.

Note: The shingles vaccine is not covered by Part A or Part B, but it may be covered by your Medicare Advantage (MA) plan or your Part D prescription drug plan.

  • Cardiovascular disease (behavioral therapy). As a Medicare recipient, you also get a free yearly visit with your primary care provider to help you lower your risk for cardiovascular disease.
  • Lung cancer screening. An annual test with low-dose computed tomography (LDCT) is free if you are between 55 and 77, don’t have any signs of lung cancer, are a smoker or have quit in the past 15 years, and you have a tobacco smoking history of at least 30 “pack years” (meaning you smoked an average of one pack a day for 30 years).
  • Depression screening. A yearly screening is free if conducted in a primary care center where follow-up and referrals are available. Copays may apply for follow-up care.

When it’s time to downsize

By Marni Jameson

Downsizing the family home book

Book Description

Building on the award-winning Downsizing the Family Home, this guide—part journal, part workbook, part scrapbook—gently walks downsizers through their profound journey.

It’s just stuff! Maybe so, but sorting through it all and quieting the emotions that downsizing stirs up is difficult—whether you’re going through your own or your parents’ home. This indispensable workbook provides valuable advice and how-to checklists along with a place to reflect, record, and retain an important piece of family history, even as you let go.

Nationally syndicated columnist Marni Jameson covers these topics, and more:

  • Nostalgia: Memories—not things—matter. Learn to let go of the guilt and sadness that downsizing awakens as you sort through the feelings along with the stuff.
  • Endow: Discover why you cling to possessions, and find the freedom to move on to the next chapter in your life.
  • Downsize: Roll up your sleeves and dive in! Figure out what to toss, sell, donate, and keep, all while maintaining harmony in the family.
  • Keepsakes: Save just enough to keep warm memories alive without creating clutter.

Readers can easily apply the tips and takeaways they’ll learn here as they clear, sort, sell, save . . . and chronicle.

Insight to knowing your doctor

The Doctor Diaries: What Physicians Wish Patients Knew

Revelations about weight loss, medical information on the internet, and more

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Most doctors want to be trusted confidants of their patients.

En español |  Joanne Jarrett, M.D., polled dozens of doctors to find out what they’d tell you if only they could, and here are the results. 

We are working on your case, even if it looks like we have disappeared.

Physicians often forget how scary being in the hospital can be. Rest assured that when the doctor is not at your bedside, he or she is writing up your evaluation, the plan and the orders outlining what needs to be done for you, all the while checking for test results and recalculating the diagnosis and plan. You may not see him or her until the next day, but your doctor or the physician on call is available by phone continuously to address your concerns.

When we keep you waiting, it’s not because we think our time is more valuable than yours.

But if the patient before you mentions blood in his or her stool or talks about suicidal impulses, your appointment needs to wait. Your best bet is to schedule the first appointment of the day.

We need complete honesty from you.

This means telling us what drugs you’ve taken, legal and illegal, so we can help you avoid interactions. It means answering honestly about sexual function and behavior, even if you fear we wouldn’t approve. We think no less of patients who struggle with mental or emotional issues.

We know lifestyle change is hard and boring.

We try and fail often ourselves. But sometimes diet, exercise and/or alcohol abstinence really are the best treatments.

Many of us have post-traumatic stress disorder (PTSD).

I have nightmares about patients down an infinite hall, each with a problem worse than the last. In my short career, I’ve seen a baby take her last breaths. I’ve watched a woman, bleeding uncontrollably after giving birth, lose consciousness as I worked, a pool of her blood expanding at my feet. I’ve heard a woman, after having both legs traumatically severed, saying goodbye to her father, assuming she wouldn’t survive. I could go on. We know we signed up for it. But keep in mind, when you’re tempted to be angry with your doctor, that we are under stress, too.

We wish we had better advice for weight loss.

Medical schools don’t spend much time on nutrition. Although body weight has significant, holistic health implications, the field of medicine is at somewhat of a loss here. Our best advice, however vague it might be, is to increase your physical activity, avoid processed foods and eat vegetables at most meals.

Yes, some of us are jerks.

Most doctors mean well and are doing their best. But if you are not getting a sense that your physician, although human and harried, has your best interests at heart, find one who does.

We worry about you.

We lie awake worried sick about you more often than you’d imagine. We may wonder about you for years after you leave our care. The stakes are so high, and we know it.

Sometimes the internet is right.

There, I said it. You can find useful health information online. We love a well-read, inquisitive patient, and we’ll be happy to touch on any of your internet-fueled fears. Just be careful. The internet can lead you to unnecessary panic or to dismiss something that shouldn’t be ignored. And be wary of discussion boards; incorrect advice can be very convincing. Remember, there is no substitute for medical training, experience and complex analysis.

We know you’ve answered this question already.

We’re sorry to ask again. When you call for an appointment, you’re asked what’s going on. Then, when you’re checked in, you’re asked again. So when you finally get to see the doctor, you’re sick of the story. But we can’t help it. We have to hear it with our own ears.

We make mistakes.

Our fear of screwing up is exhausting, weighty and ever present — it’s the hardest thing about doctoring. We do make mistakes. Be wary of anyone who won’t admit that.

Falls frighten us.

Especially for patients in their 60s. We see the transformation from healthy and active to ill and dependent far too often, and frequently it’s because of a fall. A preventive measure: Stand next to a strong countertop, then stand on just one foot without holding on. If you need support before the five- to 10-second mark, your balance should be addressed.

We want you to make decisions while clearheaded.

Having a written description of your medical-treatment wishes (an advance directive) will ease emergency situations for you, your care team and your loved ones. All hospital patients are asked what their wishes would be if their breathing or heartbeat were to stop, but it’s better to make a clearheaded decision when you’re not gripped by fear. You can find a legal advance directive form at AARP’s Advanced Directive Forms.

Tell us if you are having memory issues.

Feeling as though your memory’s failing is scary, especially as you reach your 60s and 70s. But memory issues are often caused by things a doctor can help with (depression, heart problems, medication effects and hormone abnormalities). Oh, and avoid multitasking. It’s overrated.

Antibiotics hurt if they can’t help.

We need to reserve antibiotics for susceptible bacterial illnesses. When we prescribe them inappropriately, such as for a viral illness, we do little more than undermine our ability to treat disease in the future.

We are trusted confidants.

I had a patient for years who finally opened up to me about her long-standing depression. She said she hadn’t told me sooner because she didn’t want to ruin my impression of her. Confide in us. Mental health issues are more common than you realize; the more we know, the more we can help.

We dread retirement.

It’s a cliché that doctors don’t retire, but one reason we’re reluctant is that we’re afraid of no longer being useful. Patients who seem happier in retirement have support networks, plus activities that feel helpful or significant.

Rolling back Medicare Part D… Tell Congress NO!

AARP: Don’t Mess With Medicare Doughnut Hole Deal

Rolling back the Part D prescription drug agreement would harm millions of older Americans

Prescription medication next to money

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AARP sent a letter to leaders of Congress asking lawmakers to keep a budget agreement that helps lower the costs of prescription drug expenses for some Medicare beneficiaries.

Prescription drug bills for older Americans could climb even higher if Congress reverses a budget agreement that would provide some relief from soaring costs a year earlier than expected, AARP CEO Jo Ann Jenkins warns in a letter to leaders of the Senate and House of Representatives.

As part of the comprehensive budget deal earlier this year, Medicare Part D beneficiaries who have high prescription drug expenses were promised some financial relief. These older Americans currently have to pay more for the medications they rely on. That’s because of a quirky aspect of Part D called the coverage gap, also known as the doughnut hole.

This gap has gradually narrowed since the Affordable Care Act was enacted in 2010 and was scheduled to close completely in 2020, when beneficiaries in the gap would be expected to pay 25 percent of the cost of their prescription drugs.

The recent budget deal helped accelerate that process by requiring certain pharmaceutical manufacturers to pay more of the costs for enrollees who are in the coverage gap. Currently, brand-name drugmakers pay 50 percent of enrollees’ brand-name drug costs while they are in the doughnut hole. Under the budget law, they will pay 70 percent starting in 2019. The higher discounts will help push enrollees through the coverage gap more quickly and into catastrophic coverage, under which they will pay substantially less for their medications.

The pharmaceutical industry has been lobbying to overturn this deal since it was enacted and has enlisted the support of lawmakers on both sides of the aisle. No legislation has been introduced that would overturn the agreement, but AARP is urging congressional leaders to leave the doughnut hole fix as is.

“It is imperative that we keep in place policies that will help to lower drug costs for beneficiaries and make it easier for them to access medications they rely on,” Jenkins says in her letter. “We urge you to stand with beneficiaries and resist any attempt to undo these important reforms.”