The Golden Keys for the Golden Years Update

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For healthy aging, here is the golden keys for your golden years ahead.

Aging is a natural process. Everyone is getting older each day, from birth to death. No matter what age you are, today is the youngest day in your life ahead. You are lucky when entering your golden years, as some couldn’t make this far and never had a chance to enjoy their golden years in the life journey. Therefore, be grateful for where you are now in life. Enjoy your freedom of your lifetime; understand as you came with nothing and will take away nothing from this world. The material things don’t really matter much.

Happiness nurtures life and enhance health. Practice self-care to live your best life - 

1. Enjoy life now. Don’t scarify quality of life for the sake of save money. Be mindful of your time and whom you spend time with. Live in a full life today, put away the past and don’t be anxious about future.

2. Slow down and set your own pace. You don’t have to be the super man/woman to do everything and trying to meet all other’s needs.  Do one thing at a time and do the things you enjoy. You will sparkle your moments in the ordinary days.

3. Let the sunshine into your heart and break the darkness. By this age, you have gone a long way and experienced too much. Let go and get out of the shadow of the sadness. Smile, relax, and be peaceful, walk into the nature to feel the energy of life. You will become strong from sad experiences, you will become brave from vulnerableness,  you become accountable from responsibilities, and you become independent when you have to stand alone without fears.

4. A job title and salary grade is not that important.  Gains and losses serve its purpose - no loss; no gain.  Everything comes and goes in life while you are moving on. A major issue today will be minor by tomorrow, a big event this year will be a story in the next year, and a great happening in life will be history in the future.

5. Don’t mind too much of others opinions. Humans have eyes in common, but they see the world differently. Humans have ears in common, but they hear things differently. Humans have mouth in common, but what they say is different. People think differently and live in different ways.  Trust your own instinct, not necessarily what others think or say.

6. You have the right to say “no”.  You don’t have to struggle under pressure. You know better of your own wills and limits.  You will not be able to please everyone and you do not have to be in control of everything. Refusal for unpleasant request is your best protection. You are open-minded and fearless.  Your key objective is health and happiness. Respect your own freewill and live your way of life.

7. Understand Mother Nature; don’t fight or worry too much for things you don’t have control of.  No need to be too concerned for the unknown and always apprehensive.  

8. Keep a young heart and good spirit. A healthy mindset will determine your attitude for life. Do the things you enjoy to do and go to the places you want to go now, don’t wait. For the items on the wish list, keep up the hopes.

9. Value your true feelings and treasure your loved ones. You are lucky if you have someone is taking care of you and be grateful. ​If not, please take good care of yourself. Keep a simple life with well-balanced nutrition, physical activities, and rest, to maintain body and mind fitness. 

10. When you are satisfied, you are happy. Friendships, nature, learning, peace, young heart and open mind, love, sharing, gratitude, generosity and good health will keep you happy on your golden years’ journey.

Quality Life Forum health coaching will be your trusted ally and resource along your way.  Feel free to contact qualitylifeforum@outlook.com for your health coaching needs. 

Best wishes for your happiness.

Intermittent Fasting Update

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Part I - Exploratory Discussions

Is intermittent fasting a viable option for weight loss?  Most weight loss researches are focusing on what to eat or not to eat, metabolic rate, calorie intake vs. energy expenditures, etc; but not much on when to eat and frequency of intakes. Furthermore, do humans need to be fed 3 times a day and nibbles in between? Lions in the wild can go days without food and gorge in up to 66 pounds of meat at one setting is rather normal.

Although major research efforts have focused on how specific components of foodstuffs affect health, relatively little is known about a more fundamental aspect of diet, the frequency and circadian timing of meals, and potential benefits of intermittent periods with no or very low energy intakes. The most common eating pattern in modern societies, three meals plus snacks every day, is abnormal from an evolutionary perspective. Emerging findings from studies of animal models and human subjects suggest that intermittent energy restriction periods of as little as 16 h can improve health indicators and counteract disease processes. The mechanisms involve a metabolic shift to fat metabolism and ketone production, and stimulation of adaptive cellular stress responses that prevent and repair molecular damage. As data on the optimal frequency and timing of meals crystalizes, it will be critical to develop strategies to incorporate those eating patterns into health care policy and practice, and the lifestyles of the population.

Few recent scientific studies suggest that there is great potential for adulthood lifestyles that incorporate periodic fasting to promote optimal health and reduce the risk of many chronic diseases.

Animal studies have documented robust and replicable effects of fasting on health indicators including greater insulin sensitivity, and reduced levels of blood pressure, body fat, IGF-I, insulin, glucose, atherogenic lipids and inflammation. Fasting regimens can ameliorate disease processes and improve functional outcome in animal models of disorders that include myocardial infarction, diabetes, stroke, Alzheimer ’s disease and Parkinson’s Disease. One general mechanism of action of fasting is that it triggers adaptive cellular stress responses, which result in an enhanced ability to cope with more severe stress and counteract disease processes. In addition, by protecting cells from DNA damage, suppressing cell growth and enhancing apoptosis of damaged cells, fasting could retard and/or prevent the formation and growth of cancers.

Recently studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity in part by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions.

Research studies have shown that reducing your daily caloric intake by 20 to 40 percent is an effective way to lose weight and improve cardiovascular and metabolic health. However, it’s very difficult to eat less every day for a long time. So people are looking for more manageable ways to improve their health, and many are turning to intermittent fasting — short periods of eating little to no energy-containing food and drink. 

A scientific study finding, which published on Nature Medicine, 2025, reported intermittent fasting is effective for weight loss and improves cardiovascular health in people with obesity problems.

Part II - Intermittent Fasting Methods, Guidelines and Practical Tips

Part III – Key Points and Considerations

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Caution –Studies of fasting regimens have not been performed in children, the very old and underweight individuals, and it is possible that fasting would be harmful to these populations. Therapeutic fasting should be under close medical supervision. As clinical data on intermittent fasting for weight loss is very limited to date, consult your personal physician for your nutritional needs and weight management.

References:
The scientific approach to intermittent fasting, 2016, by Dr. Michael VanDerschelden
The complete guide to fasting, 2016, by Jason Fung, MD and Jimmy Moore
http://www.pnas.org/content/111/47/16647.full
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/
http://scopeblog.stanford.edu/2016/07/07/intermittent-fasting-fad-or-science-based-diet/
https://sciencebasedmedicine.org/intermittent-fasting/
http://easacademy.org/trainer-resources/article/intermittent-fasting

https://www.sciencedaily.com/releases/2025/01/250108144146.htm

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Immunity and Aging

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The immune system helps protect human body from foreign or harmful substances. Examples are bacteria, viruses, toxins, cancer cells, and blood or tissues from another person. When growing older, the body’s immune function declines.

While some people age healthily, the conclusion of many studies is that, compared with younger people, the elderly are more likely to contract infectious diseases and, even more importantly, more likely to die from them. Respiratory infections, influenza, and particularly pneumonia are a leading cause of death in people over 65 worldwide. The aging process somehow leads to a reduction of immune response capability, which in turn contributes to more infections, more inflammatory diseases, and more cancer.

How to protect overall immunity?
A strong immunity is the first line defense for illness. Healthy life style and behaviors are the essential factors. The immune system will functions better when protected from environmental assaults and bolstered by healthy-living strategies.

Although the immune response is a body function you can’t control, these healthy habits and behaviors will benefit immunity:

1. Prioritize sleep and maintain regularity of daily routine: During sleep, your immune system releases proteins that help fight off infection. Sleep deprivation may decrease the production of these protective cells. Maintain adequate sleep (7 – 9 hours at night) is beneficial for good health. Sufficient rest will allow body to recover from physical fatigue and mental exhaustion.  Human body has an internal body clock that follows a daily 24-cycle known as a circadian rhythm. The body clock, also known as a circadian clock, responds primarily to environmental cues, such as light and darkness, as well as genes that influence how quickly or slowly our body clock runs and, as a result, how closely it aligns with the 24-hour day. Nearly every tissue and organ in the body is governed by its own circadian clock, which is responsible not only for controlling our sleep patterns, but for synchronizing every biological process — body temperature, blood pressure, hormones, etc, to the time of day. When the body clock is disrupted, whether by occasional or continuous interruptions of sleeping patterns, and the natural circadian rhythm is either slowed or accelerated, may impair body immunity.

2. Exercise safely and regularly – Being active contributes to general good health and therefore benefits the immune system.  However, extremely challenging physical activities and high intensity training is a stressor to the body and weaken the immunity. Exercises also support self control of extreme emotions and mood swings and maintain a peaceful and content mentality.

3. Healthy eating and keep body weight within normal range for your age: There appears to be a connection between nutrition and immunity in the elderly. Micronutrient malnutrition, in which a person is deficient in some essential vitamins and trace minerals that are obtained from or supplemented by diet, can be common in the elderly. Healthy immune system warriors need good, regular nourishment. Eat healthy food rather than processed food or supplements. For example, a whole orange has more nutritional value than the orange juice or vitamin C pills.  

4. Maintain good personal hygiene and proper hand washing reduce the risks of infections. DO NOT smoke and limit alcohol intake.

5. It is important for older adults to keep preventive care and keep vaccines current.

            

Vaccination for older adults

The most important vaccinations seniors should discuss with their physicians include the flu vaccine, pneumococcal vaccine to prevent pneumonia, shingles vaccine, and COVID-19 vaccine.

A reduction in immune response to infections has been demonstrated by older people's response to vaccines. For example, studies of influenza vaccines have shown that for people over age 65, the vaccine is much less effective compared to healthy children (over age 2). But despite the reduction in efficacy, vaccinations for influenza and S. pneumoniae have significantly lowered the rates of sickness and death in older people when compared with no vaccination.

Go to https://qualitylifeforum.weebly.com/2025-jan-immunity-and-aging-update.html to learn more for Influenza Vaccine, COVID 19 Vaccine, Pneumococcal Vaccine, Shingles Vaccine, and Tdap vaccine for adults. 

The take home messages

• A strong immunity is the first line defense for illness and it is built overtime. No magic for a quick fix. Healthy life style and behaviors are the essential factors. The immune system will functions better when protected from environmental assaults and bolstered by healthy-living strategies.
• Well regulate quality nutrition, exercise, and rest/sleep is the key to build and maintain a strong immune system.  Most importantly, keep up a positive, peaceful, and content mentality.  Emotional state and mood swings weaken the immune system.
• Many products on store shelves claim to boost or support immunity, but the concept of boosting immunity actually makes little sense scientifically. 
• Vaccination for prevention is strongly encouraged for older adults, as immune systems tend to decline over time, putting seniors at higher risk for certain diseases.   The most important vaccinations seniors should discuss with their physicians include the flu vaccine, pneumococcal (pneumonia) vaccine, shingles vaccine, and COVID-19 vaccine.

References:
https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system
https://www.ncoa.org/blog/4-important-vaccines-seniors-covered-medicare/

Music learning and Practice Benefits for older adults update

Music is in our lives. Music engages not only your auditory system but many other parts of your brain as well, including areas responsible for movement, language, attention, memory, and emotion. Many begin music learning and musical instruments practice in early childhood, with or without self-motivation. This is great, as it will become a valuable personal asset to benefit later in life. It is never too late to start or re-start at any age. 

Reading music and playing a musical instrument is a complex activity that comprises motor and multisensory (auditory, visual, and somatosensory) integration in a unique way. Music has also a well-known impact on the emotional state, while it can be a motivating activity. The piano is one of the most difficult and rewarding instruments to learn; you have to learn to read notes and translate them to the keys, you have to do it with both hands at the same time, you also have to learn to play with correct technique, dynamics, timing, pedals, and more.

Findings from selected research studies suggest many benefits -

Study 1 - Effects of music learning and piano practice on cognitive function, mood and quality of life in older adults

A small Barcelona study ( N = 41, with 29 completed), published in Nov, 2013, aimed the specific effects of musical training vs. the effects of other leisure activities(physical exercise, computer lessons, painting lessons, among other) in elderly people. It reported a significant improvement on the piano training group on testing that measures executive function, inhibitory control and divided attention. Furthermore, a trend indicating an enhancement of visual scanning and motor ability was also found. Finally, in this study piano lessons decreased depression, induced positive mood states, and improved the psychological and physical quality of life of the elderly. These results suggest that playing piano and learning to read music can be a useful intervention in older adults to promote cognitive reserve (CR) and improve subjective well-being.

Study 2 - Individualized Piano Instruction enhances executive functioning and working memory in older adults

A small study (N = 39, with 31 completed), published in July, 2007 by East Carolina University and the University of Florida, evaluated transfer from domain-specific, sensorimotor training to cognitive abilities associated with executive function. This study examined Individualized Piano Instruction (IPI) as a potential cognitive intervention to mitigate normal age-related cognitive decline in older adults. Results of this study suggest that IPI may serve as an effective cognitive intervention for age-related cognitive decline.

Study 3 - The Benefits of Music Instruction on Processing Speed, Verbal Fluency, and Cognitive Control in Aging

A small study (N = 70, with 46 completed), published in 2010 by University of South Florida, Tampa, examined the effects of active music instruction in piano compared with music listening instruction on executive function in healthy older adults (ages 60-85). This study concluded that group piano instruction and music listening instruction can enhance cognitive abilities in processing speed, verbal fluency, and cognitive control. A novel and progressively difficult curriculum that facilitates focused attention and concentration with complex bimanual coordination may successfully contribute to preserving cognitive abilities in aging. While simple coordination exercises are performed automatically, complex motor tasks typically require additional focused attention and executive control for older adults. Musical training contains many essential components of a successful cognitive training program such as task novelty, bimanual coordination, and progressive difficulty.

Although these studies were small in sample size, the findings are promising and we hope to see more scientific studies with supporting data in the future.

 The Benefits for Adult Piano Practice

Asymmetrical bilateral coordination is for those tasks where the two sides do different things. To coordinate two-sided or bilateral movements, the brain needs to communicate between both its hemispheres through the corpus callosum. Bilateral coordination plays an essential role in improving cognitive function. Regular piano practice and building hand/finger independence benefit brain health.

There are many benefits of learning to play piano in adulthood (not for competition or performing purpose), as learning promote cognitive functions and practice enhance complex motor skills. Positive feed-backs have been reported in -

• Mental focus and concentration
• Memory enhancement activation and maintenance
• Mind-Sight-Hand coordination
• Self discipline
• Relaxation and stress reduction
• Creativity and expression
• Positive emotions and happiness

The Advantages Of Adult Piano Practice

Starting adult piano lessons and regular practice has unique advantages:

• Adults chose piano for the purpose of learning; both the process and results are meaningful.
• Adults read, understand and apply instructions in a mature nature.
• Adults are self-motivated and self-disciplined for practice.
• Adults will be able to enrich piano studies from reading books, watching tutorials and listen to CDs/concerts.
• Adults are free to select the music of their own preference.
• Adults in retirement have more time to enjoy practice and gain satisfaction from new skill-set.
• The sound of music brings happiness and enhances quality of life.

Tips for adulthood music learning and piano practice:

1. Make a commitment for life-long learning. Learning will not be an overnight success, but with persistent effort. Calm down your frustrations during practice and having fun while pursuing your goals.

2. Taking beginner adult piano lessons on-line it’s a good place to start, which is convenient and affordable (or free). You set your own pace and routine. Enroll in group lesson or private lesson are also options.

3. If you took piano lesson in the past, but have not practiced for a long time, you probably thinking that you don’t remember anything. In fact, it will be much easier to re-start, just allow some practice to pick it up again. A re-fresh course is also a good idea.

4. Choose a favorite music piece appropriate for your level; don’t be afraid of few technical challenges.
5. Listen to it first will be very helpful, if available. This will help to train your ears and guide you for the tempo, rhythm, main theme, etc. Listen to it as often as needed.

6. Break down the master piece into small sections, hands separately, for practice. Target a single technical difficulty at a time then move on to the next.

7. Monitor your practice and correct mistakes promptly; do not repeat the mistakes overtime. It is important to listen and checking carefully.

8. The ideal daily practice time block for best result is at least one hour. Note: Taking 10 minutes at a time six times a day may not be as effective as practicing one hour a day for results, as the first 10 – 15 minutes are mostly warming up and bring you up to where you were previously. You will then moving on and making progress at each practice session toward perfection.

Learning to play an instrument is a great experience to boost brainpower, to master new skills, and bring you more enjoyable moments in life. Give it a try and enjoy.

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Healthy Eating: meat-based diet or plant-based diet?

What to eat is an essential question for human survival and we are facing it at each meal every day. It’s very easy to come across conflicting information, especially in the health science regards meat-based diets in comparison to plant-based diets.

So, Which One Is Better? The debate is ongoing and each side has sound arguments. There is no clear winner at this time. Also to mention a recent study “Mortality in vegetarians and comparable nonvegetarians in the United Kingdom,”  published in Dec, 2015, concluded that United Kingdom–based vegetarians and comparable nonvegetarians have similar all-cause mortality. A 2022 study reported that the overall health of people following plant-based diets appears to be generally good, with advantages but also some risks, and the extent to which the risks may be mitigated by optimal food choices, fortification and supplementation is not yet known.

Nutrition has its unique importance during the aging process. However, either eat meat or not, you have healthy options. Humans are living longer; older adults are enjoying energetic and active lifestyles well beyond retirement age. Health science is evident that eating well and being active can make a big difference in the quality of life.

You are never too old to enjoy the benefits of improved nutrition and fitness. With nutrient-rich foods, fitness, and social activities, you are entering a new dimension of life. In fact, as you are getting older, food and activity choices become even more important to your body.

More Nutrients, Fewer Calories

As human body age, we need fewer total calories, but more nutrients, especially protein, B-vitamins and calcium. In terms of nutrition, quality is more important than quantity. All personal food choices, for every food group, need to be power-packed with more nutrients per calorie. For both optimal physical and mental health, older adults truly need to make every calorie count.

The golden years are definitely not the time for extreme diets or drastic weight loss. The goal should be to eat better while eating less. Fad diets frequently eliminate entire food groups, which can lead to serious nutrient gaps. Rapid weight loss often leads to a loss of lean body mass, exactly the opposite of what older people need for good health. It is worth to note that knowing both being overweight and being underweight is associated with an increased health risk, however, the increase in health risk is much greater with increasing underweight than with increasing overweight. While overweight and obesity pose a significant health risk, extreme underweight is associated with an even higher health risk.

Aim for a stable weight as you get older and keep the BMI with normal range. The right balance of foods and activities could help lose more fat, while maintaining strong muscles and bones.

The Protein Power

The meat-based diets in comparison to plant-based diets, the main point to remember here is that protein isn’t the same. Human in all ages need protein to build strong mussels and healthy bodies.  The key difference between animal and vegetable protein is in their amino acid profiles and the rate at which our bodies can absorb amino acids and put them to use. Because animal protein is more similar to protein found in the human body, it is used up more rapidly than those found in plants.

Senior Malnutrition and Vitamin Deficiencies

Malnutrition is seen in varying degrees in the elderly, along with varying vitamin deficiencies. Malnutrition is due to under nutrition, nutrient deficiencies or imbalances. Mild malnutrition symptoms may include loss of appetite, general malaise or lack of overall interest and wellness.

Common nutrient deficiencies of dietary origin include inadequate intake of vitamin A, B, C, D, E, folic acid and niacin. Malnutrition may also be the result of some socioeconomic risk factors.

The USDA food patterns suggest that people 50 or older choose healthy foods every day from the following:

• Fruits — 1-1/2 to 2-1/2 cups [What is the same as 1/2 cup of cut-up fruit? A 2-inch peach or 1/4 cup of dried fruit]
• Vegetables — 2 to 3-1/2 cups [What is the same as a cup of cut-up vegetables? Two cups of uncooked leafy vegetable]
• Grains — 5 to 10 ounces [What is the same as an ounce of grains? A small muffin, a slice of bread, a cup of flaked, ready-to-eat cereal, or ½ cup of cooked rice or pasta]
• Protein foods — 5 to 7 ounces [What is the same as an ounce of meat, fish, or poultry? One egg, ¼ cup of cooked beans or tofu, ½ ounce of nuts or seeds, or 1 tablespoon of peanut butter]
• Dairy foods — 3 cups of fat-free or low-fat milk [What is the same as 1 cup of milk? One cup of yogurt or 1-1/2 to 2 ounces of cheese. One cup of cottage cheese is the same as ½ cup of milk.]
• Oils — 5 to 8 teaspoons [What is the same as oil added during cooking? Foods like olives, nuts, and avocado have a lot of oil in them.]
• Solid fats and added sugars (SoFAS) — keep the amount of SoFAS small [Note: when eat too much SoFAS, there will be not enough calories for the nutritious foods to take-in.]

Vegetarians/vegans can be at risk of malnutrition due to limit animal food sources, which cause deficiencies in Vitamin B12, Calcium, Iron, Zinc, Vitamin D, Omega-3 fatty acids, magnesium, and high-quality protein. These deficiencies may be associated with increased risk for certain types of cancer, stroke, bone fractures, preterm birth, and failure to thrive. Avoiding consumption of animal-sourced food may also be related to higher rates of depression and anxiety. Hair loss, weak bones, muscle wasting, skin rashes, hypothyroidism, and anemia are other issues that have been observed in those strictly following a vegan diet. Researchers concluded that a whole foods diet with animal foods may be a more effective dietary approach to improving life expectancy, according to a 2022 comprehensive review. 

Ensuring adequate nutrition and proper intake of vitamins and minerals will help keep our aging population feeling more vital and ultimately healthier, with a proactive preventive approach rather than intervention.

Personal Food Choice

Food choice is a personal decision.  Honestly, we are not only eating for what we “should” because it’s good for us, but also eat for our taste satisfaction and pleasure.   A good balance between healthy eating and pleasure eating is the key for sustained health benefit and happiness.  

If you love meat, you have a rich source of protein and no limitations of all food groups.  Keep in mind for portion control and avoid high fat.

If you only eat plant food, you have a lot of plant protein options.  Remember to keep up with essential nutrients and limit high sugar/carbs.







 The take home messages

• There is no right or wrong answer for eating meat-based or plant-based only.
• The protein is different, from animal or plant food source, to meet human nutritional needs.
• As human body age, we need fewer total calories, but more nutrients, and to focus on nutritional quality not quantity.  Our goal should be to eat better while eating less.
• Food choice is a personal decision.  A good balance between healthy eating and pleasure eating is the key for sustained health benefit and happiness.
• Ensure adequate nutrition intake. Enjoy healthy eating as rewards for healthy aging.

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References
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691673/
http://www.eatright.org/resource/food/nutrition/dietary-guidelines-and-myplate/healthy-weights-for-healthy-older-adults
https://www.naturade.com/vegetable-protein-vs-animal-protein/
http://www.aplaceformom.com/blog/seniors-nutritional-needs/

https://www.saintlukeskc.org/about/news/research-shows-vegan-diet-leads-nutritional-deficiencies-health-problems-plant-forward

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613518/#:~:text=The%20higher%20risk%20of%20cancer,reduce%20cancer%20risk(27)

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Facing a Terminal Illness

When shocking news of a terminal illness confirmation comes in, it becomes a turning point of life. End of life is real but we are often unprepared. 

Crisis management

Facing terminal illness represents a personal and family crisis. It impacts the patient and his/her family, as family is the primary resource for care and support. Every member of the family is going through the difficult time with their loved one, along with the illness progression.  You don’t have to fight alone. Reaching out for help when needed, there are many resources available, from healthcare system, health insurance network, private health coaching, social services, community and friends, for support.

Allow yourself to feel complex emotions and take your time to calm down your mind. After dealing with the initial shocking and emotional experiences - fear, anger, resentment, denial, helplessness, sadness, and frustration; acceptance will eventually come in confidence to face with the reality and reset life. Go forward with hope and a plan for what you want to do and accomplish.

Make health care decisions

This is the most important decision to make and it is a personal one. Take your time to well understand your treatment plan options and palliative/hospice care before making this decision.

Key steps including:

*Learn about your diagnosis – learn everything you can, the prognosis, progression, treatment options including efficacy, safety and cost and set treatment priorities as you wish.

*Learn and think about end of life and palliative/hospice care, lifespan vs. health span, and level of quality of life.

*Establish a practical support network to maintain daily routine and care.

Address financial and legal issues

It’s time to think through and make a living will and a will. Careful consideration of both the legal and financial aspects of your illness can bring a sense of control and peace of mind.

A Living will 

This is a heavy topic. No one wants to think about end of the life; however, it is wise to thought it out before the unexpected illness strikes. With a peaceful mind at a leisure day, answer a few questions -

1. In case of cancer or other life-threatening/terminal illness, what medical treatment you want or don’t want? Life extension or quality of life means more? Treatments are hopeful or too risky?  Pursue unknown% chance of treatment success rate or choose comfort and palliative care is more realistic? These critical decisions are personal.  To fully understand each treatment options for its action and side effects, asking questions and reaching out for reliable resources. You have the right to know everything to make your decision, including comfort care, artificial feeding, and cardiopulmonary resuscitation.

2. Who do you trust to make medical care decisions when you are unable to do so? Consider a person, whom you trust and also with high health literacy, to make care decisions for you as power of attorney when you are not able to make care decisions for yourself.  This person should fully understand your wishes and act for your best interests/benefits.

3. What you want others to understand you values and respect your life
It is wise to have a living will, to make your wishes clear, well known, and respected. This may take some thoughts. The Five Wishes can be a helpful tool.

You may also plan and draft a will at any time. When you are ready to make it legal, meet with a lawyer in your state.  Many people asking the difference between a living will and a will; they have very different functions and it is important to have both.

A Living Will contains your thoughts and wishes regarding whether you do or do not want to be kept alive by artificial means if you are at a point, due to accident or illness, where the doctor says there is no longer a hope of recovery for you. It is a chance to give your family guidance as they struggle, in a highly emotional situation, to figure out what you would have wanted them to decide for you.

A Will

A Will contains your wishes for how you want what you own to be distributed among your family and friends once you pass away. It can also contain instructions for the care and support of your family members, such as naming a guardian for your minor children. It is a road map of instructions that should be prepared in accordance with the laws of the state in which you reside.

Address health care expenses

Medicare/Medicaid benefit coverage (if applicable)

Supplemental/private Insurance coverage (if applicable)

Update financial documents and beneficiaries and plan care of your dependents

 

Get documents in order

Organize legal documents and other important personal information, may include:

·        Will

·        Trust documents (if applicable)

·        Living will or directive to physicians

·        Health care power of attorney, or HCPOA

·        Durable power of attorney, or DPOA

·        Health Insurance Portability and Accountability Act, or HIPAA, form

·        Adoption papers (if applicable)

·        Veteran's discharge papers (if applicable)

·        Prenuptial agreement (if applicable)

·        Marriage certificate (if applicable)

·        Divorce decrees (if applicable)

·        Death certificate of a spouse (if applicable)

·        Citizenship papers, if not born as a U.S. citizen

 

Other important information can include:

·        Inventory of assets with account numbers and passwords, including safe-deposit box access

·        Digital assets and passwords like photos or music stored in the cloud

·        Access to your computer

·        A list of contacts

·        Receipts for funeral arrangements

·        Obituary and services guidance

Managing self-care and emotional needs

Be open for your emotional needs and optimize self-care for physical comfort. Create a comfortable home setting for remission recovery.  Learning to face your emotions, manage stress, pursue activities that bring your meaning and joy. If need additional outpatient help, may consider private health coaching and homecare services for care and support.

In addition, there are resources for self-help and support, see selected links below, as well as disease specific support groups are also available.

https://www.helpguide.org/harvard/dealing-with-a-loved-ones-serious-illness.htm
https://www.livestrong.org/
http://www.alz.org/index.asp

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Reducing Aging Eye Fatigue Update

Eye fatigue is a common compliant in many older adults. Symptoms may include
    Fatigue
    Eye Pain
    Blurred Vision
    Double Vision
    Burning
    Watery Eyes
    Dry Eyes
    Sore Neck
    Photophobia (sensitivity to light)
    Concentration difficulties
    Headaches
Excessive and intense computer usage can also cause additional symptoms such as:
    Difficulty focusing when looking from paper to monitor screen
    Afterimages when looking away from monitor screen

Understanding Age-related Vision Changes

As part of aging, your eyes and vision change over time. While not everyone will experience the same symptoms, the following are common age-related vision changes:

• Need for more light. As you age, you need more light to see as well as you used to. Brighter lights in your work area or next to your reading chair will help make reading and other close-up tasks easier.
• Difficulty reading and doing close work. Printed materials can become less clear, in part because the lens in your eye becomes less flexible over time. This makes it harder for your eyes to focus on near objects than when you were younger.
• Problems with glare. When driving, you may notice additional glare from headlights at night or sun reflecting off windshields or pavement during the day. Changes in your lenses in your eyes cause light entering the eye to be scattered rather than focused precisely on the retina. This creates more glare.
• Changes in color perception. The normally clear lens located inside your eye may start to discolor. This makes it harder to see and distinguish between certain color shades.
• Reduced tear production. With age, the tear glands in your eyes will produce fewer tears. This is particularly true for women experiencing hormone changes. As a result, your eyes may feel dry and irritated. Having an adequate amount of tears is essential for keeping your eyes healthy and for maintaining clear sight.
• Go to Aging Eye Facts to learn more.

How to prevent eye fatigue?

1. Take a break - Use the 20-20-20 rule: every 20 minutes, take a 20-second break and look at something 20 feet away. Take a longer walk in nature to extend far vision in green landscapes will benefit more. 
2. Blink frequently - Do not forget to blink periodically. Staring at computer screens can dry our eyes and cause redness and irritation.
3. Use proper lighting - Use incandescent lighting and avoid high-intensity lamps, which cast shadows and create glare. Place a dim light on either side of your workstation to create equal brightness without dark, shadowed areas.
4. Use artificial tears to refresh your eyes when they feel dry.
5. Use an air cleaner to filter dust and a humidifier to add moisture to the indoor air.
6. Reduce contact lens wear: If you wear contact lens, do not leave them in for more than 12 hours a day. Let your eyes well rest for a good night sleep.
7. Eye protection: wearing sunglasses to prevent sunlight damage.
8. Good nutrition and sufficient quality sleep.

 Home Remedies for relieve eye strain 

1. Massage and eye cupping - Massaging the area around the eyes (manually or use an eye massager) will help relax the muscles and stimulate the tear glands. Also try rub your hands together to create friction and warmth, then gently cup your palms over your closed eyes, may also put a gentle pressure on the eye balls and rest them in the dark for 30 seconds. Slowly open and look around.
2. Eye exercises – regular eye exercises can alleviate eye strain, improve circulation, focus, and concentration. Roll your eyes in both clockwise and counter-clockwise for a few seconds. Then take a break and blink, repeat few times.
3. Cold compresses: Apply a cold water soaked washcloth to tired, dry eyes (keep your eyes closed).  Other alternatives are cold rose water or whole milk soaked cotton balls, refrigerated cucumber or potato slices.
4. Warm compresses are also effective in reducing pain and swelling: use warm water soaked clean towels or warm tea bags.   

Tips for Eliminating Screen time/Computer Eye Strain

1. Use quality glasses or consider computer glasses - Computer glasses are prescription eyewear that are specifically designed for computer work. They allow you to focus your eyes on the distance of a computer screen, which is generally farther away than reading material. Computer glasses optimize your eyesight when you're looking at digital screens and help to reduce glare.
2. Keep your screen bright - This reduces the flicker rate of the computer and reduces fatigue. Flickering can lead to eyestrain and headaches. Also, a bright monitor causes your pupil to constrict, which results in a greater range of focus. This reduces the need for your eye to accommodate and enables you to work longer and with more comfort.
3. Check your monitor’s position - The position of your computer monitor can add to your eyestrain. It is important that it be positioned at the proper distance away from your eyes. Optimally, your computer screen should be 15 to 20 degrees below eye level (about 4 or 5 inches) as measured from the center of the screen and 20 to 28 inches from the eyes.
4. Adjust your screen resolution - Make sure your monitor has a high-resolution display. A higher resolution produces sharper type and crisper images, reducing eye strain.
5. Minimize glare - Clean your monitor regularly to remove dust and consider installing an anti-glare screen. It also helps to keep shades drawn to prevent glare from outside sources.
6. Eliminate overall computer, tablet, and smart phone usage time. Block time to turn your personal electronics off, i.e., on evenings and Saturdays.

Schedule a comprehensive eye exam

You should get your eyes checked at least once a year, especially as you grow older. Be aware of cataracts development, when aging or injury changes the tissue that makes up your eye's lens. At first, the cloudiness in your vision caused by a cataract may affect only a small part of the eye's lens and you may be unaware of any vision loss. As the cataract grows larger, it clouds more of your lens and distorts the light passing through the lens. This may lead to more noticeable symptoms, such as

• 
  •    Clouded, blurred or dim vision
  •     Increasing difficulty with vision at night
  •     Sensitivity to light and glare
  •     Need for brighter light for reading and other activities
  •     Seeing "halos" around lights
  •     Frequent changes in eyeglass or contact lens prescription
  •     Fading or yellowing of colors
  •     Double vision in a single eye

Routine eye exams give you the opportunity to discuss with your eye-care professional any issues you may be having, and they may enable you to catch any problems in their early stages.

Ask your doctor about vitamins and supplements - Getting the proper amount of vitamins and minerals is important for overall as well as eye health. Vitamins that contain antioxidants and ingredients may benefit the health of the eye and reduce eyestrain, such as Lutein, vitamins A, C and E with a B complex and Zinc.
 

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References:
http://www.eyehealthweb.com/eye-strain/
http://www.aoa.org/patients-and-public/good-vision-throughout-life/adult-vision-19-to-40-years-of-age/adult-vision-41-to-60-years-of-age?sso=y
www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/dxc-20215129
http://www.eyehealthweb.com/eye-strain/
http://www.top10homeremedies.com/how-to/reduce-eye-strain.html
http://visionsource.com/blog/tips-for-eliminating-computer-eye-strain/

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