One Option in Funding Long-Term Care Insurance

Funding Long-Term Care Insurance with a 1035 Exchange
Many people assume they cannot afford long-term care insurance to protect themselves and their families from the financial, emotional and physical sacrifices needed to provide long-term care for a loved one. However, long-term care premiums are a reasonably small expense when compared to paying for care out of pocket, as these costs can run as high as $100,000 a year.

Despite these facts, finding ways to pay for premiums is still a genuine challenge for many families seeking coverage. Fortunately, there are several funding options available to help people on tight budgets pay for long-term care insurance, including 1035 exchanges.

A 1035 exchange is a specific transfer of funds from one life insurance policy, endowment policy or annuity policy with no gain or loss, meaning it is not taxable.

Due to new opportunities resulting from the Pension Protection Act of 2006, annuity owners can also use their non-qualified annuity to pay long-term care insurance premiums tax-free. By using a 1035 exchange, consumers may transfer the value from a life insurance policy into a long-term care policy.
One reason many people move forward with this type of exchange is because their previous policy is outdated or needs revising. Individuals may often be looking to place their policy with a different company. In either case, consumers should make sure the wealth they have built up in the existing policy is not lost.

The exchange should not be more than the single premium of the long-term care policy. Consumers must also pay the difference if the exchange is less than the amount of the single premium.

As families across the nation begin to organize their households for fall, it’s important for everyone to have a retirement plan in place that secures their financial future. A long-term care policy can help and with 1035 exchanges, even consumers on tight budgets do not have to be without protection.

You will want to speak with a long term care expert if you would like more information on this option or if you have additional inquiries on how long term care insurance can help you or someone you know. One local resource is Mike Westling.  A quick phone call to him will give you more insight on how to navigate your retirement.  

Mike Westling, CLTC
Assured LTC Planning, LLC
Advancing the self-insured to self-assured
612-867-8100 personal line

Living with Urinary Incontinence

When an older adult is dealing with incontinence, embarrassment may stand in the way of seeking treatment.
Over 25 million Americans experience incontinence. Yet most seniors who are dealing with the condition may well feel that they are all alone, because this isn’t a topic that comes up very often! They may avoid discussing the issue, even when family caregivers know there is a problem.


But it is very important that seniors discuss this issue with their healthcare provider. Left untreated, incontinence usually worsens, and can be the first step to a debilitating withdrawal from life, with decreased social connectedness, physical activity and intellectual stimulation. Incontinence causes skin irritation, interferes with sleep, and can lead to depression. It is so important to seek help for the condition.

What is urinary incontinence?

Urinary incontinence is the inability to maintain control over the release of urine from the bladder. The causes of incontinence vary widely, as does the degree of the problem. Incontinence may be brought on by illness, fatigue, confusion, or a hospital admission. It also may be caused by weakening of the muscles which control bladder outflow, disorders of the central nervous system or obstruction to the bladder.

It is helpful to be able to distinguish between the different types of incontinence:

  • Urge incontinence occurs often in seniors and can be the result of neurological damage, strokes, diabetes, or the aftermath of bladder infections or kidney stones. In this circumstance, the individual does not receive a signal in time to reach the bathroom before the bladder begins to empty itself.
  • Overflow incontinence occurs when small amounts of urine leak from a bladder that is always full due to such conditions as obstruction, constipation or nerve damage. In men, enlarged prostate is often the cause.
  • Stress incontinence means the involuntary passing of urine during any increase in abdominal pressure, such as coughing, sneezing, laughing or lifting heavy objects. It is often seen in women who have had relaxation of the muscles of the pelvic floor, usually due to childbirth.
  • Functional incontinence occurs when a person has normal bladder control, but is unable to get to the toilet on time because of a mobility problem. Alzheimer’s and other types of dementia may also be a factor; people with these conditions may not be able to think about getting to the toilet or may forget how to get there and negotiate clothing.

Can incontinence be treated?

Many people believe that incontinence is just “a normal part of growing older.” But this isn’t necessarily true. Yes, incontinence becomes more common as we grow older, but in many cases, it can be treated effectively.
So at the first sign of incontinence, it is important to consult a physician to determine its cause and type. The person’s physician can diagnose and treat underlying diseases, check and reevaluate medications that might cause or increase incontinence, and evaluate the severity of the problem. The patient may be asked to keep a “bladder diary,” recording incidents of incontinence and the amount and frequency of urination. Ultrasound and other tests provide an idea of bladder volume, as well as any blockages or other contributing factors.

A variety of treatments are available, including:

Bladder training. The patient keeps a chart of urination and leaking, and then works out a bathroom schedule, planning trips to the toilet at certain set times (for example, once an hour).

Pelvic muscle exercises, such as “Kegels,” can strengthen the bladder muscles and the muscles of the pelvic floor. This helps hold urine in the bladder longer. The time can be gradually extended so that urine is held for longer periods.

Medications. Some commonly prescribed drugs stop bladder contractions; others relax the muscles to prevent urgent or frequent urination. In post-menopausal women, estrogen pills, creams or patches may be prescribed.

Surgery. While only a physician can tell if treatment would be effective for any particular case, surgery can be effective, especially in treatment of stress incontinence and incontinence due to prostate enlargement.
Lifestyle changes. The physician may recommend cutting down or eliminating caffeine, alcohol and tobacco products. All can increase incontinence by irritating the bladder.

When treatments don’t completely work… 

People who are living with incontinence may feel more secure wearing special absorbent, disposable undergarments which are inconspicuous and quite effective in masking the incontinence. These undergarments are sold in drug stores and supermarkets, and though they don’t “solve” the problem, they may bring a sense of peace of mind and dignity to your loved one.

If mobility problems prevent the person from making it to the bathroom in time, consider having a commode chair nearby.

Specially designed clothing makes it easier for people with arthritis, stroke or Alzheimer’s to negotiate fasteners in time.

How can family help?

When dealing with an incontinent loved one, tact and sensitivity are always necessary. Try not to overreact if an older family member or friend has an accident around you. Dignity is a fragile thing in all of us, and it is something we all need to maintain. This is one of those occasions in which you need to be particularly careful in your caring.

But it’s also important to talk about the problem with your loved one, and encourage him or her to seek treatment. The National Association for Continence estimates that the average senior waits close to seven years to report the problem to the doctor! The sooner treatment begins, the better.

For More Information

Source: Assisting Hands® in association with IlluminAge, © IlluminAge 2013

The National Association for Continence website offers information and support for older adults and caregivers, including the Bladder and Bowel Diagnostic Tool.

The National Kidney and Urologic Diseases Information Clearinghouse website includes extensive information and resources on urinary incontinence.

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Ten Great Ways to Take Care of Your Brain

“Where did I park?” You dashed into the mall, visited a few stores, and now, shopping bags in hand, you realize you can’t remember where you left the car.

“I’ve met that fellow several times…what is his name?” Names, phone numbers, even familiar words…things sometimes seem to be “on the tip of your tongue” but escape quick recollection.

Woman Who is Proactive About Her Health

When you think about your own aging, what concerns you the most? Did you know that more people report apprehension about memory loss than about heart disease, cancer, osteoporosis or any other condition?

It is true that we experience memory changes as we age. Our speed of recollection and the amount of detail we remember decline. We become more likely to experience the classic “absentmindedness,” especially when we are “multitasking” and not paying full attention. Many of us worry that these changes might be symptoms of Alzheimer’s disease or other dementia.

This is certainly not an unreasonable concern. According to a recent report from the Alzheimer’s Association, one out of eight people will develop dementia, many of them living for decades with the disease. While not “an ordinary part of aging,” Alzheimer’s disease, stroke, Parkinson’s and other conditions that cause cognitive impairment are more common the older we get. These conditions can have a negative—even catastrophic—impact on our memory and other areas of cognitive health.

Yet, here is the good news. For most of us, the basic aspects of memory will remain pretty much the same: our vocabulary and language skills, reasoning and logic, the ability to pay attention, acquired skills like playing the guitar or cooking an omelet…and that special quality that we usually refer to as “wisdom.”

As with so many aspects of aging, brain fitness varies from individual to individual. Some of this is hereditary. Yes, genes are a factor. But just as you can keep your body in shape by following a wellness regimen, there are also steps you can take to make it more likely that your memory will remain sound. Here are some great things to remember:

1. Remember to…practice good nutrition. We can choose foods that help protect our brains. The good news is, if you are one of the many adults who try to follow a “heart smart” diet, you are also on track for “brain smart” menu choices. A study by Columbia University researchers confirmed that a high level of “good cholesterol” (HDL) is associated with a lower risk of dementia. Avoid: cholesterol, saturated fats, trans fats. Choose: fish, fruits, vegetables, and healthy fats such as olive oil or canola oil. Take a multivitamin—but don’t take megadoses that could be toxic. Even on a day-to-day basis, nourishing meals improve alertness and help us retain memories.

2. Remember to…stay physically active. Just as a “heart smart” diet helps protect the brain, heart-strengthening aerobic exercise improves memory and even lowers the risk of dementia. A National Institute on Aging-funded study showed that moderate aerobic exercise can actually increase the size of the area of the brain involved in memory formation. Indeed, according to a study by University of Wisconsin-Milwaukee researcher J. Carson Smith, “If you are at genetic risk for Alzheimer’s disease, the benefits of exercise to your brain function might be even greater than for those who do not have that genetic risk.” Talk to your healthcare provider about an exercise program that is right for you.

3. Remember to…sleep well. You’ve probably noticed that when you don’t get enough good quality sleep, it is harder to concentrate the next day. And did you know that memories of the day are “filed away” in the brain while we sleep? People who suffer from sleep disturbances often experience memory problems. But many sleep disorders are treatable, so speak to your healthcare provider if you experience trouble falling asleep, bothersome wakeful periods during the night, or snoring (which might suggest sleep apnea—a disorder that causes interruption in breathing during sleep).

4. Remember to…treat depression and avoid stress. Both cause chemical changes that can damage the brain. If you are feeling overly stressed, or if depression is making it hard for you to focus and concentrate, talk with your healthcare provider. Counseling, meditation and other relaxation techniques can all help.

5. Remember to…quit smoking and limit alcohol consumption. Many substances found in cigarette smoke damage the brain and impair memory. A study from Kaiser Permanente demonstrated a startling 172% increased risk of dementia among heavy smokers! And while a number of studies suggest that drinking in moderation might actually be beneficial, having more than a drink or two per day can be toxic to the brain.

6. Remember to…challenge your mind and memory. Mental stimulation encourages new connections between brain cells…so when it comes to the memory, “use it or lose it” isn’t just a cliché. Seek out a variety of mentally challenging activities. Learn a new skill—take up an instrument or study a foreign language. Join a club, volunteer, find extra ways to increase brain-protecting social interaction. Visit a museum or work a difficult puzzle. Passive activities, such as watching TV, don’t offer the same benefits.

7. Remember to…have a memory fitness strategy. It is actually possible to increase memory sharpness through training. Visualization, concentration and other effective memory skill techniques skills improve the retention and accessing of memories. And people of every age now use supplemental technology—everything from simple sticky notes to voice recorders, personal organizers, day planners…the possibilities are endless.

8. Remember to…use seatbelts and wear a bike helmet. Head injury can cause catastrophic damage to the brain and memory. And whether on the road or at home, take proactive steps to protect against falls. Remove clutter that might trip you up, install handrails by stairs and in the bathroom if needed, and ask your healthcare provider about a fall prevention class.

9. Remember to…bring up memory concerns at your next healthcare appointment. Share with your doctor if you have experienced problems, especially disorientation, forgetting recently learned information, or a sudden inability to complete familiar tasks. While it’s tempting to be in denial about memory impairment, early diagnosis of conditions such as Alzheimer’s or mini-strokes allows treatment to begin right away. And when problems stem from a reversible or controllable condition, the sooner treatment begins, the better!

10. Remember to…have your healthcare provider review your medications. Our lives are improved and extended by many of the medicines we take—but over-medication and the side effects of some drugs can dull the memory. Common culprits: tranquilizers, sleeping pills, pain medications, high blood pressure drugs. Your physician may switch you to a different drug or dosage to lessen the effect.

Why add stress to your life by worrying about your memory? Learn about the normal memory changes associated with aging, do all you can to take care of your brain, check out memory compensation strategies…and relax, knowing you’re doing everything you can to keep your memory strong through your later years.

Source: Assisting Hands® in association with IlluminAge, © IlluminAge 2013

Medication Safety for Seniors

For many seniors, medications play a big role in managing health problems. Remember, however, that all medications, whether prescribed by a doctor or bought over the counter, have potentially toxic side effects that can cause significant problems. Read on to find out several simple but important steps for avoiding the risk.

There are two types of medications: prescription drugs (which can only be taken under a doctor’s supervision) and over-the-counter medicines, which are available without a prescription. Both types are serious medicines, and need to be used properly, both individually and in combination with other medicines.

Medicines play an important part in improving health and prolonging life. They are beneficial in controlling many of the diseases and other health concerns that seniors experience, such as arthritis, diabetes, high blood pressure, osteoporosis and heart disease. Sometimes the right medication can prevent hospitalization or reduce the length of a hospital stay.

Any single medical disorder may require the use of more than one drug. And a patient may have a combination of conditions or diseases that requires the use of several different medications. The more conditions and drugs involved, the more caution is required in order to avoid side effects—unintended bad results from a drug. In seniors, side effects can cause depression, increase the risk of falls, even mimic dementia.

Some drugs are known to cause potentially serious problems for seniors. As we age, our bodies begin to respond differently to medications. For example, it takes longer for substances to be eliminated from the body than it did when we were younger, so we may need a lower dosage of a drug. And the side effects of some medications may become more serious. Overmedication, a major concern with many seniors, can occur if a person…

  • fails to stop using a drug when directed by the prescriber
  • uses another person’s medications
  • takes a medication in excess of recommended dosage
  • uses a number of different medications which have a similar effect.

Some drugs can also have serious interactions with certain other drugs. For patients seeing two or more care providers at the same time, this presents a special challenge. It is important to keep a complete, updated list of the medications a senior takes—both prescription and non-prescription—and take this list along to each visit to a health care provider.

In addition, the patient should carefully follow the prescribed regimen (frequency of dosage, length of treatment, proper storage, consumption with or without food, and so forth) in order to ensure the best results and minimize the risk of adverse effects.

A person’s health care practitioner needs certain information about the medications the patient takes. He or she may ask:

  1. What prescription and over-the-counter medications are you currently taking?
  2. How are you taking them?
  3. What medications are you allergic to, and what happens when you take those medications?
  4. Have any medications ever caused undesirable side effects, such as rash, headaches, drowsiness, dizziness or nausea?

Medication Safety Do’s and Don’ts

Here are some important facts for seniors and their loved ones to know about taking medications:


DO bring a list of all medications—prescription and over the counter—to doctor visits, and have the doctor review all medications.
DO be sure to take all the medication prescribed for you.
DO have a system to remember what medications you’ve taken and when to take them, especially if you take several different drugs.
DO drink a full glass of water when taking tablets or capsules. Always take them standing or sitting—not lying down.
DO chew chewable tablets thoroughly and wash them down with a glass of water.
DO shake bottles of liquid medications before use.
DO always store medications out of the reach of children.
DO take antacids or laxatives either two hours before or two hours after taking other medications.
DO try to use a single pharmacy to fill all your prescriptions; your pharmacist can help you avoid drug interactions.
DO report any symptoms to your doctor. He/she will help you decide if the symptoms are caused by the medication, and if you should stop taking it.
DO be alert for side effects that could increase the risk of falling, such as dizziness and balance problems, fatigue or drowsiness, confusion, loss of coordination or weakness.


DON’T take more or less than the prescribed dosage, unless directed to do so by your doctor.
DON’T stop taking a medication suddenly without checking with your doctor—even if you feel better.
DON’T mix alcohol and medicine, unless approved by your doctor. Many drugs react in a negative way when combined with alcohol.
DON’T take medication prescribed for someone else or give yours to another person.
DON’T keep old or expired medications.
DON’T ignore side effects—call your physician!

Source: Assisting Hands® in association with IlluminAge, © IlluminAge 2013

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Sleep On It: How Snoozing Strengthens Memories


When you learn something new, the best way to remember it is to sleep on it. That’s because sleeping helps strengthen memories you’ve formed throughout the day. It also helps to link new memories to earlier ones. You might even come up with creative new ideas while you slumber.

senior sleeping

What happens to memories in your brain while you sleep? And how does lack of sleep affect your ability to learn and remember? National Institutes of Health (NIH)-funded scientists have been gathering clues about the complex relationship between sleep and memory. Their findings might eventually lead to new approaches to help students learn or help older people hold onto memories as they age.

“We’ve learned that sleep before learning helps prepare your brain for initial formation of memories,” says Dr. Matthew Walker, a sleep scientist at the University of California, Berkeley. “And then, sleep after learning is essential to help save and cement that new information into the architecture of the brain, meaning that you’re less likely to forget it.”

While you snooze, your brain cycles through different phases of sleep, including light sleep, deep sleep, and rapid eye movement (REM) sleep, when dreaming often occurs. The cycles repeat about every 90 minutes.

The non-REM stages of sleep seem to prime the brain for good learning the next day. If you haven’t slept, your ability to learn new things could drop by up to 40 percent. “You can’t pull an all-nighter and still learn effectively,” Walker says. Lack of sleep affects a part of the brain called the hippocampus, which is key for making new memories.

You accumulate many memories, moment by moment, while you’re awake. Most will be forgotten during the day. “When we first form memories, they’re in a very raw and fragile form,” says sleep expert Dr. Robert Stickgold of Harvard Medical School.

But when you doze off, “sleep seems to be a privileged time when the brain goes back through recent memories and decides both what to keep and what not to keep,” Stickgold explains. “During a night of sleep, some memories are strengthened.” Research has shown that memories of certain procedures, like playing a melody on a piano, can actually improve while you sleep.

Memories seem to become more stable in the brain during the deep stages of sleep. After that, REM—the most active stage of sleep—seems to play a role in linking together related memories, sometimes in unexpected ways. That’s why a full night of sleep may help with problem-solving. REM sleep also helps you process emotional memories, which can reduce the intensity of emotions.

It’s well known that sleep patterns tend to change as we age. Unfortunately, the deep memory-strengthening stages of sleep start to decline in our late 30s. A study by Walker and colleagues found that adults older than 60 had a 70 percent loss of deep sleep compared to young adults aged 18 to 25. Older adults had a harder time remembering things the next day, and memory impairment was linked to reductions in deep sleep. The researchers are now exploring options for enhancing deep stages of sleep in this older age group.

“While we have limited medical treatments for memory impairment in aging, sleep actually is a potentially treatable target,” Walker says. “By restoring sleep, it might be possible to improve memory in older people.”

Source: Assisting Hands® in association with IlluminAge, © IlluminAge 2013

“Remember When…?” The Value of Reminiscing


All people reminisce. Remembering times past is a pleasant diversion, stimulates the mind, and helps give us perspective and a sense of who we are. As a study from the Association for Psychological Science stated, “Nostalgia is now emerging as a fundamental human strength.”

Reminiscing, the process of “life review,” is an important part of old age. As seniors recall their accomplishments and come to terms with past conflicts and disappointments, they achieve a heightened sense of personal identity and meaning in life.
Reminiscing also enhances self-esteem. Studies suggest that seniors who are encouraged to share events from their lives with others experience an increased sense of peace and self-worth. We all have a lifelong need to see ourselves as unique individuals, and the recollection of pleasant experiences, past accomplishments, and triumphs over adversity is part of this.

Reminiscing can be an important tool for socialization. Think about what happens when you first make a friend: you spend much time “filling each other in” on your life history—who you are and have been, where you have lived, who is important in your life. When a senior moves to a nursing home or assisted living community or begins to receive care in the home, sharing memories is a great way for staff to get to know the person better by learning about their life stories and accomplishments.

Reminiscing can be especially important for cognitively impaired persons. Those with Alzheimer’s disease or other dementia can often recall long-past occasions better than the events of the current day, since the disease affects long-term less than short-term memory. Interactions that include the recollection of events past can have a positive effect on the dementia patient’s emotional well-being.

Why Does My Loved One Repeat the Same Stories?

Sometimes family members and friends are concerned if an older loved one repeats stories, returning to the same ones again and again. But recognize that this, too, is part of the life review process: the repeated stories are probably those that the person finds the most pleasant to recall, or they may concern events that he or she is “working through.” Remember that a response from you is not necessarily required; your loved one may just need you to listen in a non-judgmental manner.

Sometimes an older adult may seem to dwell upon life experiences that cause sadness, anger or frustration. Understand that this, too, is a way of dealing with the past and can be a sign of emotional health. Allow these feelings to come out, and don’t try to suppress such expressions by immediately attempting to cheer up or distract your loved one. But if he or she seems “stuck” in a particular disturbing experience or time, encourage your loved one to speak to the healthcare provider.

Older adults are a treasury of stored experience. Life review and discussing “the good old days” is a beneficial, purposeful activity that helps older adults maintain a positive outlook. The Association for Psychological Science explains, “Nostalgia may provide a link between our past and present selves—that is, nostalgia may provide us with a positive view of the past and this could help to give us a greater sense of continuity and meaning to our lives.”

Encouraging the Sharing of Memories

If reminiscing seems beneficial for your loved one, here are some techniques that eldercare mental health specialists recommend for starting a conversation revolving around the recalling of the past:

Try a multisensory approach, using “jump starts” such as photographs, music, smells, and things to be touched.

Ask questions beginning with “Tell me about the time….” Encourage your loved one to talk about his or her childhood, school days, courtship, experiences during the Depression and wartime years, and other important life events.

Help your loved one write or record his or her autobiography. This is a meaningful task that provides the satisfaction of knowing that the two of you are producing a record that will be valued by generations to come. For some useful tips on creating a record of life experiences, visit the StoryCorps website (

Source: Assisting Hands® in association with IlluminAge, © IlluminAge 2013

The Tolls of Caregiving

Given the prevalent role families play in providing long-term care, insurance may not always seem necessary. However, the true value of long-term care insurance involves protecting the wellbeing of loved ones. Even though spouses and adult children are often willing to take on the responsibility, it’s still difficult to make the physical, emotional and financial sacrifices required to provide care for a loved one.

The toll on those caring for family members in poor health can be horrendous. On average, caregivers who suffer extreme stress lose about 10 years of their life. Caregivers also tend to have higher levels of depression, perceived stress and lower levels of self-efficacy than non-caregivers. In fact, people who spend at least 36 hours on providing care each week experience double the usual rate of depression.

Too many people don’t think about how their own health and well being will be affected when they volunteer to care for an ailing spouse or parent. While long-term care insurance can’t replace what families do, it can build on existing support by offering caregivers financial reimbursements, caregiving training and other helpful services that make providing care easier.

Don’t leave the well-being of your loved ones to chance and find out what options you have.  A local expert on Long-Term-Care Insurance is Mike Westling owner of Assured LTC Planning.  A quick phone call to him will give you more insight on how to navigate your retirement.  

Mike Westling
Phone:  612-867-8100

Take Good Care of Your Feet


What Makes Feet Hurt?

Most of us start life with trouble-free feet. What goes wrong? Of hundreds of known foot ailments, most can be traced to:

  • heredity
  • improper foot care
  • injury (often caused by shoes and socks or stockings that don’t fit well)
  • the effects of aging.

Women have about four times as many foot problems as men. As you might guess, high-heeled, narrow shoes are often the culprit.

Even a small problem with the feet can make walking difficult and painful. So taking care of your feet pays off in a big way.

Constant weight-bearing over the years may cause feet to spread and flatten, especially across the front part of the foot. You may find that you need a wider and longer shoe as you age. Be sure the shoe fits before you wear it!

Common Foot Problems

Corns and calluses

Corns and calluses are caused by repeated friction and pressure from shoes. If the first signs of soreness are ignored, corns and calluses rise up as nature’s way of protecting sensitive areas.

Neither calluses nor corns have roots under the skin; they are simply thick layers of dead skin cells. However, the pressure of this hard mass on sensitive nerves in the skin can be painful.

Many people develop calluses under the ball (the front part) of the foot. Your doctor can arrange padding to prevent worsening of this problem.

At the first sign of tenderness, pads placed on the skin around the calluses will help protect the area. (Pads over the callus will increase the pressure.)


A bunion is a deformity at the big toe joint. It occurs when the big toe slants outward at an angle and becomes swollen or tender. Bunions can be inherited, or caused by wearing shoes that are too narrow in the forefoot. Sometimes bunions are a sign of developing arthritis in older people.

Athlete’s foot

Athlete’s foot is caused by a fungus. Painful itching between toes, cracked or scaly skin, small blisters and red, irritated skin patches are usually signs of athlete’s foot or other fungal or bacterial conditions.

The best way to help prevent athlete’s foot infection is to keep feet clean and dry with a daily washing. Be especially careful to dry between toes. Use a foot powder to help feet stay drier through the day.

Ingrown toenails

Ingrown toenails have corners which have been crowded by the skin. To prevent ingrown toenails, trim nails straight across with toenail clippers. Do not round off corners. The nail should be kept trimmed to protect it from pressure and irritation. After clipping, smooth nails with a file.

To ease the pain of an ingrown toenail, wear open-toed sandals and soak feet in warm water once or twice a day.


Hammertoe is a hooked or claw-like deformity that affects millions. The most common forms are acquired, and shoes or stockings that cramp the toes may be a factor. Toe joints contract, and over a period of time, a bulge forms at the top of the joint. Hammertoes can affect overall balance and comfort.


Blisters are caused by poor-fitting shoes and socks. If blisters occur, don’t pop them—you may cause infection. If a blister breaks on its own, carefully wash the area, apply antiseptic, cover with a sterile bandage during the day, and uncover at night to let the skin breathe.

Poor blood circulation

Your feet are the “outer reaches” of your circulatory system. So cold temperatures, pressure, inactivity or smoking can restrict the circulation of blood to them. The signs are persistent, unusual feelings of cold, numbness, tingling, burning or fatigue in feet and legs. Other symptoms may include discoloration, dry skin, absence of hair on feet or legs, or cramping or tightness in leg muscles when walking. Keep warm, exercise moderately, and have periodic medical exams.


Osteoarthritis, which is usually caused by the wear and tear of the joints that comes with age, often affects the feet and inhibits movement. Proper foot care and proper padding to cushion feet are especially important for people with this condition.

Special Care for Diabetics

Diabetes can affect blood circulation. It can also lessen feeling in the feet. So diabetics are especially vulnerable to foot problems. People with diabetes should be sure to keep the feet warm, to wear non-restrictive shoes, and to always wear shoes in order to protect the feet. Checking daily for redness, cuts and cracks can prevent them from developing into more a more serious problem. If you have diabetes, see your physician about even the most simple foot problems. Avoid cutting corns or calluses and using any remedy containing salicylic acid (an ingredient listed on labels of certain corn remedies). Trim toenails carefully to avoid breaking the skin or producing an ingrown toenail.

Source: Assisting Hands® in association with IlluminAge, © IlluminAge 2013

Learn More

April is Foot Health Awareness Month. The American Podiatric Medical Association website offers consumer information on foot care (

The Centers for Disease Control and Prevention (CDC) recently updated their recommendations for diabetic foot care (

When Family Members Disagree: Holding a Productive Caregiving Meeting



You probably think that providing love, care, and support to an older member of your family is a personal thing. At one level or another, you feel a sense of responsibility. You have a role to fill. But remember, eldercare is also a family matter—an important, appropriate part of the family’s agenda. So, everyone’s goal has to be staying focused, honest, open, and fair with one another.

Assessing Your Family Strengths and Weaknesses

When your spouse, parents or grandparents need help, and other family members consult about it, unresolved family issues may get in the way of effective helping. Revisiting and reopening long-standing family issues of sibling rivalry, parental favoritism, and other family problems during the last months or years of a parent’s life is an easy trap to fall into.

The best way to minimize these problems is to be aware of their possibility and avoid them consciously. Work with your siblings and other involved family members to focus your interactions around the older person’s needs and best interests, not other family business. If necessary, have a friend or professional counselor meet and talk with you to move the discussion along.

You probably are not going to change the basic dynamics in your family. Try not to let caregiving issues become an emotional battle between family members. It helps to recognize going into the caregiving role that some people are going to give more than others. Often, there is not much that can be done to correct this imbalance of involvement. However, much can be done in terms of support and affirmation. Those carrying the major responsibility for managing or providing care need both help and appreciation. Do what you can, and support those who are doing the rest.

Family Communication Skills

When it comes to family communication, it’s never too late to improve. Even families with long histories of not communicating very well—or at all—can learn to share their views and ideas for meeting the eldercare needs of parents, grandparents, or other older relatives. If your family is “communication-challenged,” try these simple tips:

  • Think of family communication as an opportunity for personal and family growth.
  • Put your issues and concerns out on the table for discussion. Do others see the situation the way you do? Be open to give and take, but try to move in the direction of a consensus about what the eldercare needs and opportunities really are.
  • Be inclusive. Draw out what each family member is thinking and feeling, including the older person you are trying to support and care for.
  • Stick with it. Reaching consensus usually takes some work. Be willing to give it the time and effort it requires.
  • Be open to both asking for and accepting help. The whole idea is to not “go it alone.”
  • Share the load. Make sure there is basic fairness going on in terms of the financial, time, and emotional costs of the family’s overall eldercare efforts.
  • Know when to say “no.” If the “fairness” message is not getting through, or if you are simply stretched beyond your capacity, it may be a time to decline some tasks and speak with another family member about sharing them.
  • If necessary, call in a professional. A geriatric care manager, eldercare attorney or therapist can serve as mediator when things become contentious or come to an impasse.

SOURCE: Assisting Hands Home Care in association with IlluminAge; © IlluminAge 2013