The Importance of Nursing Home Activities

Many people think a nursing home is a nasty, soul-less place where residents either lie in bed or sit endlessly in a rocking chair, waiting out their days until the inevitable happens. The reality - at least in a good nursing home - is far from that. Many people enter a nursing facility when they have lots of life in them yet, and look forward to years of fun and companionship, with daily activities to keep both their bodies and brains active.

In fact, studies have shown that regular stimulating activities help half a decline in depression among nursing home residents, staving off dementia and keeping their spirits as well as their bodies alive. Activities are vital to keeping up residents' mental and physical well-being, and even staff and visiting family and friends can take part - willingly - in the activities a good nursing home provides.

If you are looking to find a nursing home for a loved one who's still capable of loving life, it's important that you discover what types of activities are on offer - and how often they are available. In fact, nursing homes that take Medicare or Medicaid patients have to have a designated activities director to get the proper funding. But how well they carry out their job is something you will have to assess yourself...

"I think the residents I talk to who tell me there is nothing for them to do but sleep, eat and read the paper are looking for purpose to get up every morning," writes Vicki30CNA on the allnurses.com website. "They do not look forward to the next day as they all run together. And our residents that are not as able get little to no stimulation besides toileting and shower. A few fold bibs every AM and see it as their 'job', but that job takes them a half hour. Then what, they tell me. I hate to see their last years months days so empty and without purpose. "

If you want to avoid this from happening to someone you love, read on. A wide variety of activities should be on offer at every nursing home, so make sure this is the case when considering a nursing home. Some residents may enjoy going out for lunch several times a week, shopping or visiting the local art gallery or cinema. Others will prefer on-site activities that stimulate their hearts and minds.

It might be a good idea to have a chat with the nursing home activities director to see what's available. Here is just a handful of activities that a good nursing home should willingly provide...

Self-Starting Activities

Great as they require little preparation and can be planned by the residents themselves. They include:

Gardening. Depending on residents' scope of mobility and interest, gardening can be as rigorous or as gentle as they want it to be. If there is a real garden that's fantastic, if not then hanging baskets, small pots of herbs and indoor cactus or orchid collections can still keep the interest going.

Arts and crafts. Even older residents enjoy making something - especially when they feel it's going to a good cause. Knitting blankets, making baby clothes or entering art or photographic contests can keep people busy and help them make a contribution to society at the same time.

Games. You might think bingo is the most popular nursing home game - and you're right. But there's more to competitive games than just bingo. How about bridge, mah-jong, canasta or chess - the sky's the limit. One-on-one games are great for encouraging closer relationships among residents, and group games are also good for fostering a sense of community.

Musical-based activities. Don't limit the fun to sing-alongs - you may even have professional musicians among the residents, or you may discover some hidden talents.

Volunteer-led Activities

Nail care, Bible study, hair salon day - all you need is a volunteer with a skill - and the time to make a difference in someone's life.

School groups. It may sound cliched, but young people have a lot to learn from oldsters. This can take the form of Granny teaching little Albertine to knit, or visiting a school once a week and reading to the little ones. Many schools, in fact, encourage people from the outside - assuming they have been police-checked - to help kids who need a little bit extra with one-to-one reading or math exercises.

Local community groups. People who have a special talent often enjoy visiting nursing homes on a regular basis and sharing their skills. This can be giving residents massages or reflexology sessions, teaching them a special aspect about gardening, or giving a talk about growing orchids.

Scout groups. Often, scout troops visit nursing homes - gathering together to do something fun such as bake chocolate-chop cookies or build a birdhouse. The two groups can learn from each other and make use of each other's skills and talents.

Local charities. People from charities often give their time to older people, whether that means preparing outings or having a Pet Therapy day when the local vet or employees from the animal shelter bring animals to visit.

Nursing Home-Led Activities

Themed events, such as birthdays or religious celebrations. Some creative residents get together with staff to plan events such as Hawaiian nights, Chinese New Year celebrations or Halloween or Thanksgiving festivities. Friends and family can be invited to join in - perhaps even residents of neighboring nursing homes as well.

Outdoor activities such as barbecues, picnics or a stroll through a park or garden center. In some cases volunteers may be called on to help residents with mobility issues.

A bit of culture. Going to the theatre, opera, museum or cinema can take some planning, but its worth it. Again, volunteer helpers and drivers may be necessary.

Alternative therapies. Everyone can benefit - as long as they're not too invasive. Massage, yoga or Tai Chi can help residents have fun, get fit and relax.

Keeping people as happy and healthy as possible for as long as possible. both physically and mentally, should be the goal of every nursing home. Activities should be varied and interesting, suited to the different abilities, needs and interests of the residents. They should be not only fun but worthwhile, enabling residents to form new relationships, develop new skills, and keep up their fitness levels.

"We have a 'senior prom' in May, where the local single Marines escort our residents (wheelchairs and all) for dancing and food, writes CoachCathy on the allnurses.com site. "We have gowns and suits donated by the local thrift stores. Local hair parlors come and do the hair and nails. Everyone has a blast.

"And we had a Winter wonderland theme last December - we made snowmen with diaper boxes painted white - and had a snowman decorating contest. The residents had an indoor snowball fight (with cotton balls). It was so much fun!"

Assisted Living Facility - Taking Care of Your Special Needs

A lot of help may be required when a person grows old, and this can make it tough for families to take care of the person. Nowadays, families prefer to help elderly people move into assisted living facilities. As elderly people start needing more extra care, they can continue living a relaxed and happy life. Growing old is not a bad thing as long as there is extra care, which is what every aged person wants. The best way to offer this care is to look for a senior apartment. Considering the growing demand of these senior citizen homes, a number of facilities have been built, and each of them caters to the different needs of the elderly people. These days, families cannot take care of senior members at home because it requires a lot of time and patience. People who move into independent senior living can live their lives peacefully. The level of services offered in senior apartments varies from one facility to the next and should be chosen according to the needs of the individual.

For many people who are nearing retirement age or have already retired, choosing the best independent senior living is the biggest task. It depends on the individual whether or not to choose a regular senior apartment or assisted living, as the kind of services offered in both of these facilities varies. Special needs arise with age and it is at this time that an assisted living facility can serve all of your individual needs. Special programs are designed for people with their own specific needs. Apart from regular services like laundry or healthcare services, other personal care services are also offered in these facilities, which makes life for the elderly more relaxed and enjoyable. When people get older, they run the risk of developing any kind of physical problem, and it's at those times that a senior apartment offering special services is the ideal choice for families.

Most elderly people don't look forward to going into nursing homes, and for them the best alternative is an assisted living facility. In these facilities, recreational activities are also there to keep the elderly person involved and to maintain the quality of life of the senior citizens. Even if you opt for a senior apartment, make sure it caters to your special needs because only then the elderly person can enjoy staying in the facility. The main goal of any aged person is to live a peaceful and relaxed life, and for that the needs of the aging person need to be met. In these seniors, sometimes independent senior living can also be a good option. However, for this the person needs to be physically fit and active. So, if the senior citizen is looking to have a secure old age with special needs being taken care of and recreational activities on a regular basis, then an assisted living facility is the best choice.

Moving Mom Or Dad - Senior Care Options

As an empowered generation, the baby boomers are known for having enjoyed the 1960's to their fullest extent and are often defined as trail-blazers of radical social change around the world. As the Baby Boomers age however, they are finding themselves faced with an entirely new struggle. As medical care has improved over the years and individuals are living significantly longer, this generation is finding themselves in a complex and demanding situation of trying to provide care for both aging parents and their own children. Due to the economy, many boomers are finding themselves having to provide housing for their post-college graduate children who have moved back home as they search for jobs, while at the same time many are being faced with the scenario of having to move elderly parents in with them to provide them with sufficient care. As these circumstances arise, the Baby Boomer generation has found themselves re-branded as the "Sandwich Generation", stuck in between their aging parents and children who both require a considerable amount of care, time and energy.

As this generation watches as their parents grow older and more frail, the difficult decision looms of whether or not to move aging parents into their own homes or to a care facility. This is probably one of the most difficult decisions any child will ever have to make. Many seniors unrealistically believe that they can successfully care for themselves for the rest of their lives, and understandably so as no one wants to willingly give up their independence after a long life of independence and self-sufficiency. For this reason, many children find it difficult to approach this sensitive subject and suggest that change is needed. This hesitancy can often have negative consequences for your loved ones however, and the last thing you want to do is to have to make this decision in a crisis situation.

This is why it is important that you open up the lines of communication with aging parents early on, before the need for immediate care is staring you directly in the face. Regular conversations with an elderly parent in regards to what will need to be done should they no longer be able to provide care for themselves will prepare the both of you and will lessen the sting of words like "nursing home" and "assisted living".

Many aging parents will be resistant to the idea of leaving their own home for an assisted care facility or nursing home. When approaching this topic you should make it your problem. Stress to your aging mom or dad that is worries you to see them like this and that you are concerned for their health and safety. Few elderly parents wish to burden their children, and will often be more open to the idea of moving if they know that you are seriously concerned. You need to have the support of other family members and siblings and everyone needs to be on the same page when this subject is addressed.

An alternative to moving seniors to a new a residence is to enlist the services of a professional senior caregiver. Most adult children are too busy with work and their own family lives to provide their aging parents with the adequate care they need. A senior caregiver can help lessen this burden by taking over many of the daily care responsibilities your elderly loved one needs, therefore allowing you to enjoy your free-time with your parent rather than be stressed out and exhausted from it. Hiring a senior home care agency will also allow your loved one to remain in their own home and will save you the stress of relocating your senior loved one. Elder Caregivers can provide their services anywhere from a couple hours a day to round the clock, depending on your aging parent's needs.

Many adult children who find themselves faced with making a decision regarding their senior parent's care will often find themselves overwhelmed with feelings of guilt. They must remember however that they are doing what is in the best interest of their parent's health and safety. Knowing your elderly loved one is safe and well cared for will provide you with great peace of mind.

Baby Boomers' Addiction & Alcoholism May Take Down Medicare & Social Security Programs

There is a relatively new group to be treated for addiction and alcoholism that is growing very quickly, and which is causing some in the field great concern: It is the retiring "baby-boomer" population.

There are several reasons that the "boomer" generation may potentially be home to many more addicts and alcoholics than the rest of the population. Some of these reasons are that the boomers were (1) the first generation to engage in wide-spread recreational use of a variety of addictive drugs (including cocaine, marijuana, and methamphetamines); (2) the first generation for which a wide variety of prescription medications and painkillers were readily available; and (3) the last generation for which treatment and recovery were not culturally acceptable. For these and other reasons, some are calling it, " America's hidden epidemic". [1]

According to some studies, it is expected that, by 2020, the number of seniors with alcohol and other drug problems will leap 150 percent to 4.4 million older people - up from only 1.7 million in 2001. [2]

Deborah Trunzo, research coordinator for the SAMHSA (Substance Abuse and Mental Health Services Administration), has said that, by 2020, the number of older people who will have drug problems, and be seeking treatment, will be "likely to swamp the system".

It is the baby-boomer generation, or the "young old" - those born between 1946 and 1964 - that are at the heart of this possible epidemic. Unlike their predecessors, those in the baby-boom generation are more comfortable taking medications for a wide range of problems, including pain, insomnia, depression, and anxiety.

In addition, the baby boomers are the first generation to widely experiment with recreational drug use. Yet along with all of these "firsts", they are also the last group born before it became somewhat permissible to admit to addiction or alcoholism, or to seek help or treatment.

One of the big concerns is that the boomers are much more vulnerable to late-life manifestation of alcoholism, addiction, and drug abuse.

In addition, in more recent years, this group has been prescribed with far more painkillers, as well as newer "designer drugs" including potentially addictive psychotropics.

A. Rush Limbaugh: The Poster-Child for Late-Onset Addiction

For example, in October 2003, at the age of 55, well-known political talk-show host, Rush Limbaugh, was charged with prescription drug fraud, and admitted to being addicted to painkillers - primarily oxycodone. With Mr. Limbaugh's admission to his addiction, he became the poster child (or poster "senior") of the new type of patient showing up in treatment centers, and emergency rooms. [3]

This "late onset" substance abuse is often linked to other medical problems, and the emotional traumas that can accompany old age, which arise from isolation, injuries and accidents, the death of friends and family, and the natural aging and dysfunction of the body.

As the boomers move into retirement, and leave the work force, they may find it more difficult to maintain their drug supply of choice: On the one hand, those who obtain drugs through legal means will have less medical coverage and less money to spend on prescription drugs. On the other hand, those who rely upon illegal drugs will no longer have as much money to pay for those drugs after retirement, and many will lose "access" to those drugs from their professional vocation (think of the dentist, nurse, or paramedic, for example, who has easy access during work). Retirement may simply mean a loss of supply, the attendant consequences of withdrawal, and the need for medical treatment.

A new legion of addicts is coming, and they require a far different approach to treatment, as well as a much higher level of medical intervention and support.

B. The Need for Greater and More Specialized Treatment

In general, older adults have different needs than younger adults; and, when it comes to the treatment of addiction and alcoholism in older adults, these differences are magnified.

Typically, younger adults are more resilient, and have abused themselves for a shorter period of time, and therefore, have a much better chance of living in recovery. On the other hand, senior citizens are much more likely to drop into a long decline toward death following any significant medical event (such as detoxification).

The aged are a very vulnerable group, and are noted to have the highest rate of suicide and other complications in relation to alcoholism. [4] Older adults are also showing an increase in seeking treatment for methamphetamine use. These are just some examples of the differences and trends which make the boomers such a widely diverse group, with different histories and backgrounds, giving the group the need for a wider variety of treatment plans and responses. [5]

Also, boomers are more likely to have dual diagnosis, with untreated long-standing co-morbid mental health problems, such as ADHD, anxiety disorder, and other personality disorders, that were simply not recognized by the medical community back in the day when the boomers were younger.

Finally, the aging abused human body in retirement will require more medical attention, more care-giving, more nursing homes, more medications, and more money, on average, than one who has led a relatively healthy life.

Macroeconomics: Medicare and Social Security Programs

The greater monetary and social costs associated with older adult treatment, recovery, and medical support could be substantial. If we significantly under-estimate the number of baby-boomers that are or will be addicts and alcoholics in their retirement years, we may have greatly misjudged the overall costs to our healthcare systems.

The Social Security and Medicare Boards of Trustees just this week released the 2008 Annual Report on the Status of the Social Security and Medicare Programs. [6]

The Summary Report begins as follows:

"A MESSAGE TO THE PUBLIC:

Each year the Trustees of the Social Security and Medicare trust funds report on the current and projected financial status of the two programs. This message summarizes our 2008 Annual Reports.

"The financial condition of the Social Security and Medicare programs remains problematic. Projected long run program costs are not sustainable under current financing arrangements. Social Security's current annual surpluses of tax income over expenditures will begin to decline in 2011 and then turn into rapidly growing deficits as the baby boom generation retires. Medicare's financial status is even worse. This year Medicare's Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures than it receives in taxes and other dedicated revenues. The difference will be made up from general revenues which pay for interest credits to the Trust Fund. Growing annual deficits are projected to exhaust HI reserves in 2019 and Social Security reserves in 2041. In addition, the Medicare Supplementary Medical Insurance (SMI) Trust Fund that pays for physician services and the prescription drug benefit will continue to require general revenue financing and charges on beneficiaries that grow substantially faster than the economy and beneficiary incomes over time.

"The drawdown of Social Security and HI Trust Fund reserves and the general revenue transfers into SMI will result in mounting pressure on the Federal budget. In fact, pressure is already evident. For the second consecutive year, a "Medicare funding warning" is being triggered, signaling that non-dedicated sources of revenues-primarily general revenues-will soon account for more than 45 percent of Medicare's outlays. The President recently proposed remedial action pursuant to the warning in last year's report and, in accordance with Medicare statute, a Presidential proposal will be needed in response to the latest warning.

We are increasingly concerned about inaction on the financial challenges facing the Social Security and Medicare programs. The longer action is delayed, the greater will be the required adjustments, the larger the burden on future generations, and the more severe the detrimental economic impact on our nation."

The actuarial assumptions underlying the Annual Report are based upon the intermediate range of projected costs. As also stated in the Summary Report:

"How Are Estimates of the Trust Funds' Future Status Made? Short-range (10-year) and long-range (75-year) projections are reported for all funds. Estimates are based on current law and assumptions about factors that affect the income and outgo of each trust fund. Assumptions include economic growth, wage growth, inflation, unemployment, fertility, immigration, and mortality, as well as factors relating to disability incidence and the cost of hospital, medical, and prescription drug services. [Emphasis added.]

Because the future is inherently uncertain, three alternative sets of economic, demographic, and programmatic assumptions are used to show a range of possibilities. The intermediate assumptions (alternative II) reflect the Trustees' best estimate of future experience. The low-cost alternative I is more optimistic for trust fund financing, and the high-cost alternative III is more pessimistic; they show trust fund projections for more and less favorable conditions for trust fund financing than the best estimate. The assumptions are reexamined each year in light of recent experience and new information about future trends, and are revised as warranted. In general, greater confidence can be placed in the assumptions and estimates for earlier projection years than for later years. The statistics and analysis presented in this Summary are based on the intermediate assumptions." [Emphasis added.]

Therefore, it is possible that the current Reports significantly under-estimate the number of addicts and alcoholics in the boomer generation, the wide diversity of addiction types, and the overall health problems and medical needs of the boomers as they enter the Social Security and Medicare systems in the years ahead.

If so, the impact on the financial outlook of the systems could be catastrophic:

"What is the Long-Range (2008-2082) Outlook for Social Security and Medicare Costs? An instructive way to view the projected cost of Social Security and Medicare is to compare the financing required to pay all scheduled benefits for the two programs with the gross domestic product (GDP), the most frequently used measure of the total output of the U.S. economy. Costs for both programs rise steeply between 2010 and 2030 because the number of people receiving benefits will increase rapidly as the large baby-boom generation retires (Chart B). During those years, cost growth for Medicare is higher than for Social Security because of the rising cost of health services, increasing utilization rates, and anticipated increases in the complexity of services. [Emphasis added.]

The potential for amplified costs of treatment for a much larger population of addicts and alcoholics would rest upon the shoulders of an already absurdly large set of projected healthcare costs.

C. Conclusion

In conclusion, if the actual addiction and alcoholism rates of the retiring baby-boomers is significantly higher that our current estimate of those rates, then the overall medical and related costs to be borne by the Medicare and Social Security Programs could be substantially higher than our current predictions. This, in addition to the already high projected costs of healthcare for that group, could, in turn, impact all of us by way of the significant long-term financial impact on the United States Government.

As the Summary Report concludes:

"The combined difference grows each year, so that by 2017, net revenue flows from the general fund will total $449 billion (2.0 percent of GDP). The positive amounts that begin in 2017 for OASDI, and in 2008 for HI, initially represent payments the Treasury must make to the trust funds when assets are redeemed to help pay benefits in years prior to exhaustion of the funds. Note that neither the redemption of trust fund bonds, nor interest paid on those bonds, provides any new net income to the Treasury, which must finance redemptions and interest payments through some combination of increased taxation, reductions in other government spending, or additional borrowing from the public.

"Chart E shows that the difference between outgo and dedicated payroll tax and premium income will grow rapidly in the 2010-30 period as the baby-boom generation reaches retirement age. Beyond 2030, the difference continues to increase nearly as rapidly due primarily to health care costs that grow faster than GDP. After the trust fund exhaustion dates (2041 for OASDI, 2019 for HI), the increasing positive amounts for OASDI and HI depict the excess of scheduled benefits over projected program income. When the statutory SMI general fund revenue requirements are added in, the projected combined Social Security and Medicare deficits and statutory general fund revenues in 2082 equal 9.3 percent of GDP, indicating the magnitude of the potential effect on the Federal budget if general revenues were used to ensure payment of all scheduled program benefits. A similar burden today would require nearly 80 percent of all Federal income tax revenues, which amounted to 11.7 percent of GDP in 2007.

"To put these magnitudes into historical perspective, in 2007 the combined annual cost of HI, SMI, and OASDI amounted to 38 percent of total Federal revenues, or about 7 percent of GDP. That cost (as a percentage of GDP) is projected to double by 2060, and then to increase further to nearly 17 percent of GDP in 2082. It is noteworthy that over the past four decades, the average amount of total Federal revenue as a percentage of GDP has been 18 percent, and has not exceeded 21 percent in a given year. Assuming the continued need to fund a wide range of other government functions, the projected growth in Social Security and Medicare costs would require that the total Federal revenue share of GDP increase to wholly unprecedented levels."

While the financial outlook for the Programs is bleak, the failure to address a potentially larger problem of addiction and alcoholism in the next generation to retire could have amplified consequences for everyone.

References

(1) Jointogether.org; "Addiction Among Seniors Called 'Hidden Epidemic'; News Summary, July 21, 2003.

(2) The New York Times; "Addicts of A Certain Age: Baby Boomers Need Help." March 6, 2008.

(3) CNN.Com; "Limbaugh admits addiction to pain medication"; Oct. 10, 2003.

(4) National Institute on Alcohol Abuse and Alcoholism. Alcohol Alert. Alcohol and Aging.

(5) Hughes, Mary Elizabeth; O'Rand, Angela; "The Lives and Times of the Baby Boomers", part of "The American People" series. http://www.aginghipsters.com/blog/archives/1/000346.php; 12/16/04.

(6) Actuarial Publications; "Status of the Social Security and Medicare Programs/Summary of the 2008 Annual Reports"; Social Security and Medicare Boards of Trustees; http://www.ssa.gov/OACT/TRSUM/trsummary.html

An Old Coach Offers a Simple Solution to Childhood Obesity

Obesity is a huge and growing problem in America and around the world. And the childhood edition of this problem is a 21st century tragedy that's not only costing our nation billions of dollars, but it's costing millions of kids their confidence, their self esteem, their willingness to try something new in public for fear of failure, and consequently their capacity to live full and productive lives.

While scientists are busy studying body chemistry, body composition, nutrition, and exercise physiology, pharmaceutical companies are busy developing the latest weight loss pill, the diet industry is designing a new diet strategies, infomercials are crowing about new exercise devices, health clubs are hustling fitness, insurance companies are cutting benefits, and McDonald's is pushing salads, all in an effort to commercially take part in the multi billion dollar obesity industry. In the mean time, the problem continues to grow unabated, like a forest fire raging out of control.

An Old Coach's Reaction

In light of that raging forest fire I'd like to introduce you to the wisdom of a retired coach who I've known for over three decades. In the words of this old coach (he prefers to remain anonymous, and back in the shadows), "I taught physical education for most of my adult life and during that time I made the following observation. I noticed that kids who could perform pull-ups were never obese," he said. "And kids who were obese could never perform pull-ups. Pull-ups and obesity are mutually exclusive, and are never found in the same kids," he added.

Without Pills, Shots, or Magic Diets

The old coach's conclusion was that if you start 'em young, before they've had a chance to pick up much weight, teach them the ability to perform pull-ups, and teach them to never lose that ability, you can immunize kids against obesity for a lifetime, without pills, shots, magic diets, or much in the way of expense. "The more kids you can teach to physically pull their own weight," he said, "the closer you'll come to whipping the childhood obesity epidemic."

But Kids Hate Pull-Ups

I told the coach that I thought his logic was impeccable, but in my view he had one problem. According to my recollection, most kids hated pull-ups with a passion. And if they hate doing it, how can you teach them to perform pull-ups? They'll drag their feet all the way to the gym, won't they?

Using A Height Adjustable Pull-Up Bar

"Kids hate doing anything where they fail in public," the coach replied. "The trick is to start them young before they learned to fail on the pull-up bar. Start them out on a height adjustable bar that allows them all to succeed immediately with leg- assisted pull-ups, jumping and pulling at the same time. With this inexpensive tool you'll eliminate failure, and build regular success into the experience for all participants."

How High Do You Set The Bar

A couple of more questions popped into my mind immediately. First, how high do you set the bar when you're starting a youngster out? And secondly, how do you adjust the level of difficulty in order to insure progress? I could tell however, the wise old coach had an answer on the tip of his tongue.

The Progression

"You start the bar out low enough that the child can do at least 8 leg assisted pull-ups, but no more than 12. You allow them to work out twice a week and expect them to improve every time for a number of weeks, consecutively. In other words, in the second workout they should do 9, in the third 10, in the fourth 11, and in the fifth 12 leg assisted pull-ups. When they hit 12 repetitions you raise the bar one inch and they begin the 8-12 process all over again. This strategy allows a child to make a little progress every time he or she works out, and after several weeks they learn to EXPECT TO SUCCEED IN PUBLIC, which in turn teaches them to love instead of hate pull-ups."

They've Immunized Themselves Naturally

So if I understand it right Coach, the kids literally inch their way upward until they eventually run out of leg assistance, at which point they've not only learned to perform pull-ups, but they've also learned to love doing them, and in the process they've immunized themselves naturally against obesity for a lifetime as long as they maintain the ability. Does that sound about right, I asked?

They May Want To Be Bad, But

"Mechanically speaking that's correct," the coach said. But there are a few other things that go into the strategy that you need to understand. One thing is that you're tapping into a child's natural desire to be strong and not weak. In my years of teaching I met lots of kids who wanted to be bad, but I never met a kid who wants to be weak. And that goes for the boys as well as the girls. We all want to be strong. All kids know that the ability to do pull-ups requires you to be strong. And when you work in a group, they're getting stronger in public, and kids love to succeed in public," he said. "They inevitably finish off by giving each other high fives, and they love every second of it."

I asked the coach what other things are built into his strategy. He said kids learn that three things make them strong, including regular work, good eating habits, and getting enough rest at night and in between workouts. They also learn that fooling around with tobacco, alcohol, and drugs makes them weak. And no kid ever wants to be weak. "They also learn these concepts in a very hands-on, and concrete way," he said.

Taking Responsibility For Yourself

I knew the coach could have talked on this subject all day but I wanted to finish on one other related point. The phrase pull your own weight has responsibility taking connotations that are very appealing to most people these days. What role does taking responsibility for oneself play in this childhood obesity prevention strategy?

After congratulating me on all the good questions the old coach said, "One of the big lessons that kids learn from working on the pull-up bar is that nobody else can do it for you," he said. "I mean in reading, writing, and arithmetic you may get away with having somebody else do your homework for awhile. But the pull-up bar knows immediately if you've done the work, it knows if you're eating right, it knows if you got enough rest recently, and it pays you for doing these things with additional success.

On the other hand, it also knows if you fail to do these things, and it can just as easily deny the public success that all kids crave. So this strategy absolutely encourages kids to take responsibility for themselves in all kinds of ways," the coach said.

A Web Site Dedicated to The Old Coach's Strategy

I confessed that he'd sold me. I agreed that teaching kids to pull their own weight would go a long ways towards solving the childhood obesity epidemic, it could save our nation billions of dollars, and do all kinds of wonderful things for the individuals who learned the lessons that are built into this simple, practical, affordable, and infinitely measurable strategy. In fact I was so impressed that I offered to build an informational web site dedicated to the old coach's naturalistic vision. He took me up on the offer, and as I write this sentence you can now check out "pull your own weight dot net" if you'd like to learn more about the old coach's simple childhood obesity prevention strategy.

One Final Question

My final question to parents and educators (or anyone who works with kids) is, why wait for the experts to come up with a high tech solution when you can turn the tide naturally with your own kids right now by simply teaching them to pull their own weight? As they always say, there's no time like the present. Carpe diem.

The Medical House Assisted Living Model Can Rewrite Long-Term Care As America Knows It

The "Medical House" Assisted Living Model Can Rewrite Long-Term Care as America Knows It - It Deserves Public Funding

Angela did not really realize what she was in for when she set out to house people with certain medical issues in her Midwest assisted living residence. As a nurse she focused on the non-behavioral populations who were managing issues with pulmonary concerns, diabetes, obesity and hypertension, including survivors of stroke.

She disdained the atmosphere surrounding funds that reimbursed homes which served the mentally ill, labeling the systems that oversees these funds as laced with improper politics and the kind of constant budget cuts that made quality care impossible. Without knowing it, Angela was onto something big, and she spent $30,000.00 on television advertisement to tell the world about it. She had developed the small-scale "Medical House", an assisted living revolution still in short supply in comparison to what is really needed throughout America.

Charging from $3,000.00 to $6,000.00 per month depending upon the needs of the prospective resident after a thorough assessment, Angela's Medical House still costs much less than the average monthly fee in a nursing home for the same patient which ranges $8000.00 to $10,000.00 per month. The routine in the home is an impressive one.

Each resident receives what is called the "morning quarter", which is 15 minutes per morning devoted to nothing but observation of a resident's mood and behavior in comparison to the day before or multiple previous days which helps staff to better plan a routine for the day. Often a specific 3 questions are asked of each resident.

The "morning quarter" is then used to help plan a more person-centered and meaningful regimen that considers energy levels, response to new medications, mood swings, sorrows, sleeplessness, new personal events, appetite changes and much more.

Support staff who may work partial shifts during the day then utilize the notes made by the early morning staffer allowing all to come together until bedtime to enhance the assisted living experience on each and every day. During this process an on-line case management system is updated and messages sent to applicable nurses, pharmacists, physicians including psychiatrists, guardians and other interested parties who can receive this information without privacy violations in real-time. There are two, (2) staff on duty during the morning quarters so that one can focus on observation, documentation and reporting while the other tends to morning personal care, medications and housekeeping.

The result? Even people with special needs which includes the medically fragile elderly and those with catastrophic injuries can live in their own communities in more dignified, non-institutional settings and avoid the stigma and depersonalization which can often come with the nursing home environment.

These 6-bed environments require the right staffing, ownership that is open-minded to change and innovation, professional relationships with a competent, experienced nurse and the regular involvement of a visiting physician whose practice is aimed at the population being served including a physical medicine and rehabilitation and wound care focused doctor.

The "Medical House" would typically be licensed based upon the requirements of your state of operation. They serve a valuable purpose and provide a meaningful, effective alternative to nursing home care for many and can spare lots of pain from Medicaid budgets once bureaucrats accept with action the need to develop a national standard and provide a fee for service system for this clinically competent assisted living model.

Such a reimbursement model must be a direct bill type system without the requirements associated with contracting with an agent of Medicaid waivers. Accreditation bodies must be involved and while these businesses cannot be skilled settings along the lines of a nursing home, they can be a close cousin in terms of quality medical oversight with lots more personal attention.

How urgent that America come together so thousands more neighborhoods develop and take pride in a real family booster, ""The Medical House" for those who need someone else to be their keeper.

Thanks for allowing us to share.

Retirement In Diaspora: Are You Preparing For It? Feedback From Nigerians - Part 2

The feedback received provided insight you might find useful. The reader must know that this information is not scientific and has not been put through in-depth statistical models or evaluations. Please do your own research before adopting any of these suggestions from fellow Nigerians.

In the previous Ezine article fellow Nigerians were asked to share their plans and preparations for "The Big R," retirement. Many responded, and thanks to everyone who took the time to write.

James (last name withheld) wrote: While we struggle to live up to expectation, (Not that I know who's expectation) a lot is wasted on things without tangible future value. I have often seen that mansion in the village as a waste of valuable money but we did not grow up with the culture of investing for the future." Children are often our retirement. We need education if we don't want to become a burden to the kids or start packing in preparation for a final trip to the village as we head towards retirement.

Some Nigerians who implied or expressed that they are domiciled in Europe took the stance that the governments there will take care of their retirement, and therefore they did not have to worry about saving additional funds. "Those in Europe and Scandinavia may not have much to share, as their retirements are relatively better secured as long as they have had active working lives and have paid into the better managed retirement purse - unlike the American 401K," remarked a reader called Ayookun.

While some readers who responded have totally lost faith in Nigeria for various reasons, there are more people whose belief in Nigeria is rock solid. Those who have written Nigeria off as a place to retire or invest for retirement cite common complaints of Nigerians overseas: swindling by family and once-trusted friends in Nigeria; and terrible governance. In their experience, they have been pitched great investment ideas, only to be taken to the cleaners once their hard earned money is sent to Nigeria. Jabolondon wrote this about an uncle who was duped when he invested for retirement in Nigeria: "He appointed his brother as "Project Manager" and, since 1994, has diligently repatriated funds for the project. Fast forward to today. His house is one level of concrete blocks in a rubbish-strewn site. His brother, meanwhile, is the proud owner-landlord of a block of 4 x 4 plush apartments."

This has been a serious and perennial compliant of many Nigerians working overseas. It is quite detrimental to all parties in obvious ways: the person who is cheated not only loses his scarce retirement investment, but may inadvertently ignite eternal family feuds that do no good. Those overseas who hear these (often exaggerated) stories are dissuaded from investing or planning to retire in Nigeria. The person doing the cheating loses too, because ori otu mgba a bughi ezi - he who eats all the food at once starves once the food in his stomach digests.

However, for every five respondents who have had enough of Nigeria and don't intend to retire there, there are eleven that urge a second look. The latter group espouses the benefits of investing in Nigeria as a retirement vehicle. One prolific commentator named Patcho made a point that is very appealing to most Nigerians in Diaspora. He stated, "Eventually when retirement age comes, I'll like to retreat to my village because I want to walk around, feeling the soil barefooted in my compound and welcoming visitors who did not need to call or write me before they knocked."

Using the money Patcho said he sent home over the years, his relatives in Nigeria have helped him amass real estate holdings around his home town. Wouldn't it be great for most of us, both in Nigeria and overseas, to have the realistic option of retiring in our villages in peace and security; bringing our retirement funds to enjoy and to help further develop Nigeria?

Cajetan Nwagbara has this edited recommendation: "Go to any city in Nigeria, and buy a parcel of land. Develop it, build at least 12 flats, and rent them for N25,000 each flat per month. One can conveniently live on N300,000 income, if one has a personal house and a decent car." It is a good idea. Frankly, a retiree in a medium- to low-cost part of America can survive on $2,000 (plus Social Security income) if the Nigerian funds can be religiously sent here and the person is in relatively good health and has no mortgage on the home in the States.

Valteena summed it up this way: "Haba!!! onyeije Naija can't be that bad for you to want to erase it off completely. I beg no erase. Nigeria may yet go better." That was in response to Onyeije who wrote as if Nigeria should be wiped off the map. He said " I am just waiting for my parents to join their ancestors, then I [will] erase and obliterate that name NIGERIA from all available lexicon."

Those are heartfelt words from someone who obviously loves Nigeria but is deeply disappointed in what Nigeria has become. It is a sentiment discreetly shared by many Nigerians, especially those in Diaspora. These Nigerians resent the leadership at home who fostered the conditions that forced them to abandon their familiar environment and reside overseas, even as many who wish to leave Nigeria look up to those abroad as the lucky ones.

The mention of retirement homes in the previous article sent shockwaves to most readers. Studies show there are many great retirement homes all over the western world, but most of them also come with hefty price tags. From the feedback, it was obvious that the prospect of going to any nursing home is too hot or raw for most Nigerians abroad to deal with. Truth be told, many of us have to get serious with retirement and estate planning and funding if we are to avoid the dreaded poor nursing home dilemma.

The original article was written to awaken and bring to forefront the importance of retiring with dignity, and the need to save the necessary funds to achieve this golden age goal. You need quite a lot of money to do that, so stop wasting and start saving as if your life depends on it - because it just might.

Many of us have children, and children everywhere love their parents as much as children anywhere. Let's not lose that point in this whole healthy discussion. However, we have not come this far, worked this hard, and weathered so many storms to depend on anyone else, including our wonderful and loving children. We should spare them the worry of our finances. We should be leaving estates for them to cushion their lives, not saddling them with the financial hardship of caring for us in our old age.

Rokijola has an outside-the-box, albeit utopian, solution: "One option will be to have retirement homes in America that cater to Nigerians, and have sister retirements homes in Nigeria. These retirement homes can be operated something similar to time-share holiday homes. The greatest challenge will be managing healthcare needs, which is a given with old age."

That is one great idea, especially if restaurants serving authentic Nigerian foods are located on the premises like those near Highway 59 and Bissonnette in Houston, Texas. That area is the closest you can be to Aba, Calabar, Benin, Owerri, Jos, or Lagos without leaving America. The only food better or even close would be home cooked meal prepared by one's spouse. Sorry to digress, I just want to give a shoutout to those Houston restaurateurs; none of whom I know personally.

F. Scopion made elaborate and logical points, taking into account inflation, deflation (which is more serious), low interest income, American 401K plans, and Roth IRAs, as well as global and long-term (30-year) views. F. Scopion wrote: "Best bang for your buck, and almost the only sane option left, is to invest in an emerging economy. A lot of savvy middle class Americans are already investing in BRIC [Brazil, Russia, India, and China] countries using financial instruments. Some even travel there to buy real estate. Nigeria isn't on the list yet, because its financial system is still too opaque. My point? Investing in property in Nigeria is more than just a good idea: there is no earthly reason why you shouldn't do it, if you can. I can assure you that well-to-do Americans would jump at that chance".

Idi-ogi made a rather extreme appeal against retiring overseas but softened it by suggesting investment in Nigerian real estate. He wrote this: "Retiring abroad is not as rosy as it may first appear. When I lived in England, my wife carried out a survey involving old retired people. She met an elderly Nigerian whose wife had returned to Nigeria while he stayed in Manchester. This gentleman was unkempt and disheveled. He was malnourished because his meals were pushed over the door with no opportunity for him to make his choice known. Same for his other supplies. The workers simply left things at the door and notified him by knocking on the door. By the time he opened the door, they have disappeared into thin air."

"Investing in real estate is the way to go. The return on investment is far better in places such as Lagos and Port-Harcourt. The drawback is that there is very little opportunity to finance the huge amount of money needed. A similar investment in the US will yield minimal returns at this time, but may be easier to finance with good credit rating," he concluded,

I also receive responses that were either too personal to publish or the emailer did not want me to quote them or use their names. Those responses made me think this topic has deeper roots than I first thought. Brothers and sisters, retiring in poverty is hellish. Retirement planning and funding is neither a husband's thing or a wife's thing; it is a family jewel. One has to think about one's self and spouse first. When you REALLY need them, you cannot Western-Union back the funds you should have saved and invested in your working years.

It might be prudent to diversify and not put all your retirement eggs in one basket by investing only in Nigeria or solely in your base overseas, or in emerging markets. Those governing Nigeria should capitalize on the pull of funds held overseas by both Nigerians inside and outside the country by making conditions more attractive for these Nigerians and their funds to come home to roost.

Finally, retirement is something positive to look forward to. While it will take a long time planning and acting to achieve good results, excessive stress over saving for tomorrow could rob you of the joy and blessing of treasuring today. And too much stress might cause an untimely end that makes retirement a moot point! So thanks again to those whose responses made this article possible, and I wish all of us success as we continue preparing for retirement in prosperity, not in abject poverty.