Monmouth's Ask the Doctor May-June 2020

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Monmouth County’s Ask The DOCTOR THE HEALTH &WELLNESS MAGAZINE F R YOU ANDYOUR FAMILY SPRING 2020

Local Physicians Answer Your Health Questions

NEWS YOU CAN USE:

• Kids’ Health • Beauty • Eating Well • Fitness • Aging • ...and more : i ’ l i ll i i ...

Bellmawr, NJ

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EXPERIENCE THE FINEST IN HEALTHCARE…

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LAKE COMO, NJ

RED BANK, NJ

MANALAPAN, NJ

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WWW.ADVANCEDPMR.COM | 732.894.9200

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SPRING 2020

We understand that choosing a rehabilitative care center can be difficult. CareOne has the experience and know-how to help patients and their families receive the right care and information, and to ensure that patients return home stronger. Our physical, occupational and speech therapists help patients regain strength and independence. To that end, CareOne’s staff provides 48% more therapy per patient day than the statewide average, and 53% more than the national average.* Call today. You will have peace of mind knowing that your loved one’s care is in our hands. CAREONE REHABILITATION CENTERS

CAREONE AT HOLMDEL 188 Route 34 Holmdel, NJ 07733 732.946.4200

CAREONE AT KING JAMES 1040 Route 36 Atlantic Highands, NJ 07716 732.291.3400

CAREONE AT WALL 2621 Route 138 Wall Township, NJ 07719 732.556.1060

CAREONE AT JACKSON 11 History Lane Jackson, NJ 08527 732.367.6600

Take a virtual tour at www.care-one.com Toll Free 877.99.CARE1

*The Centers for Medicare and Medicaid Services’ Nursing Home Compare ratings

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COMPREHENSIVE PERSONAL Care Touch

DR. KIRAN MEDASANI, MD MEDICAL DIRECTOR

A t King Manor Care and Rehabilitation Center, we are dedicated to providing professional quality health care in a warm environment. Our highly experienced and devoted sta of health care professionals treat each patient with respect, compassion and dignity. Centrally located on the Jersey Shore, King Manor Care and Rehabilitation Center has been servicing the community for over 25 years.

SERVICES INCLUDE: Sub Acute Rehabilitation Long Term Residency Alzheimer’s Care & Memory Enrichment Hospice & Comfort Care Respite Hospitality

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SPRING 2020

EXCELLENCE IN DERMATOLOGY. EXCEPTIONAL CARE. The Dermatology Experience: Reimagined. We are now offering TELEMEDICINE VISITS due to the COVID-19 pandemic. Our office is complying with all CDC recommendations to ensure patient and staff safety.

FIND THE RIGHT SOLUTIONS FOR YOUR SKIN CONCERNS

• Medical Dermatology • Pediatric Dermatology • Surgical Dermatology Mohs Micrographic Surgery Skin Cancer excisions

Cosmetic excisions of moles, cysts, lipomas

• Cosmetic Dermatology

732.702.1212 NJDERMCENTER.COM

Botox, Dysport, Xeomin, Jeuveau Dermal Fillers (Juvederm, Restylane, Radiesse) Laser and IPL Chemical Peels Dermalinfusion treatments Customized Facials Skincare

479 County Road 520, Suite A201 •Marlboro, NJ 07746 Call our office to schedule your full body skin exam or personalized cosmetic consultation!

Zain Husain, MD, FAAD BOARD CERTIFIED DERMATOLOGIST Fellowship Trained Mohs Surgeon and Cosmetic Dermatologist

Ambient Rehabilitation provides outpatient physical therapy where a licensed physical therapist is with you from start to finish in your therapy sessions. We offer early, late, and weekend hours to meet your busy schedule. Get help with: Neck and Back Pain One on One Personalized Physical Therapy Ambient Rehabilitation provides outpatient physical therapy where a licensed physical therapist is with you from start to finish in your therapy sessions. We offer early, late, and weekend hours to meet your busy schedule. Due to the current virus, it is even more important that you get your Physical Therapy needs in small clinics like ours. We make every effort to clean and sanitize every piece of equipment after each use. Get help with: • Neck and Back Pain • Post‐orthopedic surgery • Fibromyalgia • Rheumatoid Arthritis • Nerve Damage • Phase 2/3 Pulmonary Rehab Locations in Hamilton, Manalapan, Monroe, & Princeton 2333 Whitehorse Mercerville Rd., Suite #8, Mercerville, NJ 660 Tennent Rd., Unit #107, Manalapan, NJ 369 Applegarth Rd., Suite #4, Monroe Twp., NJ • 60 Mt. Lucas Rd., Suite #600, Princeton, NJ Knee, foot, and ankle pain Carpal Tunnel Syndrome Joint/muscle/tendon injuries Fracture and Disloca�on Mul�ple Sclerosis Chronic headaches Sports Injuries Chronic Pain Osteoarthri�s Post‐orthopedic surgery Fibromyalgia Rheumatoid Arthri�s Nerve Damage Phase 2/3 Pulmonary Rehab Receive a 15 minute free screening with one of our licensed physical therapists by calling 732‐982‐4801 or visi�ng us at ambientrehab.com Loca�ons in Hamilton, Manalapan, Monroe, and Princeton 2333 Whitehorse‐Mercerville Rd., Suite #8, Mercerville, NJ Receive a 15 minute FREE screening with one of our licensed physical therapists by calling 732-982-4801, or visting us at ambientrehab.com 660 Tennent Rd., Unit #107, Manalapan, NJ 369 Applegarth Rd., Suite #4, Monroe Twp., NJ 60 Mt. Lucas Rd., Suite #600, Princeton, NJ • Knee, foot, and ankle pain • Carpal Tunnel Syndrome • Joint/Muscle/Tendon Injuries • Fracture and Dislocation • Multiple Sclerosis • Chronic Headaches • Sports Injuries • Chronic Pain • Osteoarthritis

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Monmouth County’s ASK THE DOCTOR The Greater Princeton Area ASK THE DOCTOR THE MILLSTONE TIMES Publishing Enterprises, Inc. GUNTHER

Kids’ Health & Camp...........................9 Information, news and expert advice to raising healthy children from pregnancy to 18 As We Age.......................................... 14 Articles and physician information just for seniors Healthy Mind & Soul. ........................22 Inspirational stories and advice on achieving mental balance and clarity The Healthy Palate........................... 26 Recipes to enjoy and local dining options for eating out Financial Health . ............................. 28 Information, resources and news related to the health and well-being of your financial future Healthy Home....................................33 Here you will find expert tips to make your home healthier, safe and fabulous I Am Beautiful. .................................. 38 Everything from tips to trends, and where to go in NJ for specialty services

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Q: What are COVID Toes?

A: As the world continues to struggle with the COVID-19 pandemic, new symptoms of the virus continue to be identified. One such symptom, purple or red lesions on the toes and hands, has been dubbed “COVID toes” and has gained attention over recent weeks. Rashes have been associated with the coronavirus more than other viral infections but not a sure and definite sign someone may have COVID.

Dr. Sanjay Gandhi, DPM

These rashes on toes are newer symptoms and have been emerging and show how people can react to infections in different ways. Some of these symptoms actually aren’t new in the realm of viral infections. It’s not uncommon for someone to have a viral infection and have a rash or blotchy area on their body. COVID toes are just another way that the body can respond to a viral infection. Should you notice a rash or COVID toes in addition to the common symptoms of the coronavirus, it’s best to contact your healthcare provider sooner than later.

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Complete Family Foot & Ankle Care

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SPRING 2020

Your Feelings During Chemotherapy

It is normal to have a wide range of feelings while going through chemotherapy. After all, living with cancer and going through treatment can be stressful. You may also feel fatigue, which can make it harder to cope with your feelings. At some point during chemotherapy, you may feel: • Frustrated • Helpless • Lonely • Anxious • Depressed

• Afraid • Angry How can I cope with my feelings during chemotherapy?

Relax. Find some quiet time and think of yourself in a favorite place. Breathe slowly or listen to soothing music. This may help you feel calmer and less stressed. For more on relaxation exercises, visit Learning to Relax on the National Cancer Institute’s web site at: www.cancer.gov/about-cancer/coping/feelings/relaxation. Exercise. Many people find that light exercise helps them feel better. There are many ways for you to exercise, such as walking, riding a bike, and doing yoga. Talk with your doctor or nurse about ways you can exercise. Talk with others. Talk about your feelings with someone you trust. Choose someone who can focus on you, such as a close friend, family member, chaplain, nurse, or social worker. You may also find it helpful to talk with someone else who is going through chemotherapy. Join a support group. Cancer support groups provide support for people with cancer. These groups allow you to meet others with the same problems. You will have a chance to talk about your feelings and listen to other people talk about theirs. You can find out how www.cancer.gov 11 others cope with cancer, chemotherapy, and side effects. Your doctor, nurse, or social worker may know about support groups near where you live. Some support groups also meet online (over the Internet), which can be helpful if you cannot travel. Talk to your doctor or nurse about things that worry or upset you. You may want to ask about seeing a counselor. Your doctor may also suggest that you take medication if you find it very hard to cope with your feelings. It’s normal to have a wide range of feelings during chemotherapy. After all, living with cancer and going through treatment can be stressful. 1-800-4-CANCER (1-800-422-6237)

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Dr. Steven Linker, OD

QUESTION: What is Optomap retinal imaging?

ANSWER:

The optomap ultra-widefield retinal image is a unique technology that captures more than 80% of your retina in one panoramic image while traditional imaging methods typically only show 15% of your retina at one time. Your retina (located in the back of your eye) is the only place in the body where blood vessels can be seen directly. This means that in addition to eye conditions, signs of other diseases (for example, stroke, heart disease, hypertension and diabetes) can also be seen in the retina. Early detection of life-threatening diseases like cancer, stroke, and cardiovascular disease. It also facilitates early protection from vision impairment or blindness. Early signs of these conditions can show on your retina long before you notice any changes to your vision or feel pain. While eye exams include a look at the front of the eye to evaluate health and prescription changes, a thorough screening of the

free. It is suitable for every age, even children. The capture takes less than a second. Images are available immediately and you can see your own retina and exactly what your eye care practitioner sees in a 3D animation. Most importantly, early detection means successful treatments can be administered and reduces the risk to your sight and health.

Check out our website for more information MONMOUTHVISION.COM

Dr. Steven Linker, OD Monmouth Vision Associates 50 Rt 9 North Suite 206 Morganville, NJ, 07751 Tel: 732-617-1717

retina is critical to verify that your eye is healthy. Getting an optomap image is fast and pain-

License # 27OA00454300 Cert. # 27OM00044200

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SPRING 2020

Parent Like a Pro: Slowing the Summer Slide By Cynthia O’Brien Learning doesn’t have to fall by the wayside just because school is out. Use these five parent pro tips to keep your child learning and having fun over the summer months. 1. “Summer”ize your Summer Activities: After completing a fun activity with your child this summer – such as going to the zoo, park, pool, etc. – have your child tell you about it. Ask questions like: What happened? Who was there? Why was this significant? What was the most important thing that took place? The more you engage with your child and allow them to give detailed accounts of activities, the stronger their sum- marizing and paraphrasing skills will be once they return to school. 2. Count the Change: Keep your children’s math game strong by allowing them to make cash purchases on your behalf. Af- ter each cash purchase, give the change to your children and have them count it. As they get more change, and they count that (addition), give them the task of buying something. Ask them if they have roughly enough (estimation). If they do, have them buy the item and calculate the change (subtrac- tion). If they don’t have enough, ask them to figure out how much more they will need (subtraction). Don’t use cash of- ten? No worries. After each purchase, have your child calcu- late the change they would get if they rounded the change up to the next dollar. 3. Seek the Silver Screen: Beat the summer heat by making a day of going to the movies with your child at an air-condi- tioned theatre. Take your children to see at least two mov- ies. Then, have them compare and contrast the plots, main characters, conflict, and resolution. You can also have them think of alternate endings or movie extensions. In addition to practicing critical thinking through comparison activi- ties, they are also engaging in summarizing, evaluating, and synthesizing ideas – all high-level learning skills that can be constantly built upon – regardless of grade or age. 4. Creature Feature: Create outdoor learning experiences over the summer with creatures and plants that surround you and your child. Give your student a container to catch an insect or hold a plant or creature. Then, help them research what they caught. Have them write down a few facts about the in- sect, plant, or creature – what it is, where it’s found, how it grows, how to take care of it, etc. Finally, display the contain- er with the written facts. Allow your children to practice the catch, report, and release activity several times throughout the summer so they can constantly be learning about the en- vironment around them. 5. If You Build It, They Will Play: Keep your child’s mind stim- ulated by exercising their imagination. A great activity to start with is to pretend that there is no electricity or batter- ies for electronic games. Using just the materials that can be found in your house, have them engineer their own game. They should create written rules that explain how the game is played and how to win. Next, play with them. This activity requires children to reimagine new ways to solve problems. And who knows, if your electricity does go out, you’ll be en- tertained for hours! Cynthia O’Brien is a 5th Grade Math/Science teacher from Maywood, Illinois and 2018-2019 School Ambassador Fellow with the US Department of Education.

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What Autism Awareness Means to Me By Timothy Rohrer

My name is Timothy Rohrer. I am a young adult with high-functioning autism. I’ve gone through challenges such as a speech delay, behavioral differences, learning difficulties, sen- sory sensitivities, and a tic disorder. I’ve also gone through social isolation by neurotypi- cal/non-disabled people during my teenaged years. Having autism doesn’t hurt because it makes me unique. But what does hurt, is facing social isolation by neurotypical/non-dis- abled people. When many of us think of Autism Awareness Day, we think of it as a day in which most of us wear blue shirts, decorate the walls with puzzle pieces, honor famous people with autism such as Albert Einstein or Greta Thunberg, and advertise slogans such as “I Support Autism Acceptance”, “Choose Kindness, Acceptance, & Inclusion”, “Different not Less”, and “Light it up Blue”. People with autism still face social isolation even though we do things to support them. Doing the things as listed above is not enough to make society more inclu- sive of those with autism. I certainly think it’s awesome to do things like wearing blue shirts and decorating the walls with puzzle pieces to honor those with autism. But as an advocate of disability inclusion, I think society needs more education all year long about Autism Awareness in order to make these things more meaningful. AutismAwareness means different things for each individual with autism. AutismAware- ness can mean being employed to certain jobs, being given the opportunity to help out in the community or specializing in physics or environmental science. But for me, Autism Awareness means being given the same friendship opportunities as neurotypical/non-dis- abled people. My main goal is to make sure that the non-disabled community gets educa- tion about how to fully understand challenges that those with autism face, how to include them as a friend, and how to communicate to their level. First off, in order to break down the barriers that socially isolate those with autism from non-disabled people, we have to teach children at a young age about autism, its challenges, how to communicate to their level, and how to include them as a friend. The main reason why neurotypical/non-disabled people seem to exclude those with autism from social in- teractions is because schools lack educational programs to teach students about Autism Awareness. Teaching children about the challenges people with autism face, how to com- municate to their level, and how to include them as a friend should be taught in classes and assemblies as much as we teach them about anti-bullying and drug awareness.

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Being socially included by the non-disabled community is a fantasy for most people with autism. Making that fantasy into a reality is possible if we work for it. As of for me, I am an author of a pamphlet designed for younger children called “How to be a Good Influence to People with Disabilities”. My pamphlet defines what a disability is and contains information about how to include someone with a disability as a friend. It has been seen and used in some places all over the world. Locally, I have had the opportunity to share my pamphlet with several groups in New Jersey and I presented my pamphlet to my local school districts. When I presented my pamphlet to children in the local districts, children asked me questions about what it’s like to have autism and how it felt when people socially excluded me. I heard news after I presented about some of the students inviting people with autism and other disabilities such as Down Syndrome & Muscular Dystrophy to their birthday parties and to playdates. Children inviting people with autism and other disabilities to their parties, playdates, and other social gatherings is what true inclusion means. My pamphlet is a great resource for children to learn from and I hope more schools in the United States and other countries can present my pamphlet to their classes. Other than my pamphlet, I believe that schools should come up with lesson plans, books, games, and skits to provide to children which will help them understand Autism Awareness/Inclusion. I want children to be taught how to approach someone with autism, invite them to sit with them at the lunch table, play with them during recess, contact them, and to hang out with them at movie theaters, restaurants, parties, etc. I attend a young adult youth group through a Presbyterian Church in Allentown, NJ. I explained about how difficult it was for me to be socially excluded. I also spoke to them about my pamphlet. A lot of the members offered their phone numbers to me and gave me the chance to hang out at restaurants, concerts, movie theaters, and other places together. I am thankful to have them as my friends. I hope more social and religious groups can offer friendship opportunities to those with autism and other disabilities too. In conclusion, being socially included by non-disabled people as an autistic person to sit at their lunch tables, text/call each other, see a movie together, grab a bite to eat, see a concert, and other forms of entertainment is what Autism Awareness means to me. I hope we can create a future in which schools and parents can educate their children about how to socially include people with autism and most of all, people with other disabilities too!

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SPRING 2020

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How Do I Talk to My Child With Autism About Coronavirus (COVID-19)? Here are ten simple tips to consider when explaining coronavirus with your child with autism spec- trum disorder (ASD) along with an excellent social story to foster understanding and help reduce anx- iety. 1. Talk to Your Child A lengthy and medical explanation is not always necessary when explaining the coronavirus to a child with autism. Since it is being heavily discussed, it is not unnatural for a child with autism to have ques- tions. Simply explain that it is a new infectious disease and was unknown until an outbreak in China in December 2019. 2. Schools Are Closing

K I D S ’ H E A L T H & C A M P Schools are a necessary part of a child’s daily routine. The closing of your child’s school can affect him/her in a multiple of ways. It will be vital that you address this situation with your child as behaviors as a sense of security can heighten when established daily routines radically change. 3. Look for Signs of Illness It is crucial you educate yourself on the warning signs of this illness. Many of you may have children with autism who can verbalize when they are feeling ill. Others may have children on the spectrum who are non-verbal and are unable to communicate their needs. As a parent, you’ll need to watch for signs of: • Runny nose • Sore throat 4. Grocery Stores Grocery stores are an excellent place for your child with autism to practice social skills. However, your child may now sense a state of panic that may be occurring within these stores. They may wonder why aisles usually filled with water, toilet paper, or hand sanitizer are now empty. Preparing your child ahead of time by discussing these situations will assist him/her with dealing with them. 5. Change in Routine Parents of children with autism often recognize the importance of routines for their children. However, trips to grandma at the senior citizen’s home, the closings of schools, and canceled travel plans may bring behavioral concerns to the surface. Discussing these changes in routine may help your child cope better with them. 6. Protective Practices Modeling proactive protective practices can be a great way for your child to learn them. Demonstrate how to wash your hands. Have fun with this activity by singing songs such as “Happy Birthday” to demonstrate how long to wash your hands before stopping. Remind your child of the importance of handwashing after using the bathroom or eating. Show your child how to move at least three away from someone who is coughing or sneezing and how to sneeze into his/her own elbow. 7. Stress With all the changes in established routines, your child with autismmay begin to become overly anxious or stressed. He/she may panic if another child is coughing or sneezing based upon a simple cold or allergies, he/she is experiencing. Keeping the lines of communica- tion open with your child may assist with reducing some of his/her concerns. 8. Staying Away from Sick Individuals Explain to your child with autism that if one of his/her classmates, friends, or relatives become sick that he/she may not be able to see or be around them for several weeks. However, thanks to social media, cell phones, and the use of video conferencing like Zoom, your child can still maintain his/her social connections. 9. Supervision Plans With the closings of schools, parents will need to be proactive with the supervision of their children at home. Many schools have closed for the rest of the school year, or have placed all classes online. If you are a working parent, you may need to seek in-home care for the supervision of your child with autism. This may involve hiring a babysitter, or having a relative come to care for your child. 10. Social Stories Social Stories are a terrific resource to use with your child with autism. Take a look at the one below to assist you with describing coro- navirus and the changes that may need to take place. This social story can become part of your daily routine and help with reducing your child’s anxiety levels. Source: Autism Speaks • Nasal congestion • Diarrhea

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SPRING 2020

Delivering Your Baby Safely During the COVID-19 Crisis By Michael Kirwin, MD

K I D S ’ H E A L T H & C A M P

Delivering your baby brings some anxiety, even in normal times. The COVID-19 crisis has added an extra level of anx- iety. While you might not have thought about COVID-19 until recently, you may rest assured that CentraState has taken the appropriate measures to ensure that you and your baby have a safe delivery. Taking Precautions to Reduce Risk When it became apparent that the coronavirus was going to affect our state, OB/GYN department chairs throughout the entire state met virtually to discuss how we could protect our patients and allay expectant mothers’ fears. We devel- oped standardized procedures that are in effect at all hospi- tals throughout the state.

For your safety and the safety of other patients and their babies: • Patients who have tested positive for COVID-19 and those who are showing symptoms of the virus will stay in isola- tion rooms in a separate area of the labor and delivery unit, away from non-positive patients. • You’ll be able to have one support person during labor. This can be a parent, friend, or partner. This visitor must be the same person during your entire stay (there is no switching out). • You and your support person will be screened before coming into the unit. If your support person has a temperature of 100 degrees or higher, they won’t be allowed to stay with you. • Once on the unit, you won’t be able to leave or have your belongings delivered to you, so be sure to bring everything you need for your stay when you arrive for admission. • Your support person must remain in your room at all times. Meal trays will be delivered to the room for your guest as well. • If your support person needs to leave, they will not be allowed to return. No alternate support person will be allowed. • Both you and your support person will need to wear masks when our staff members are in your room. • Your temperature and that of your support person will be taken several times a day. • If your support person’s temperature reaches 100 degrees at any time during your stay, they will be asked to leave and will not be able to return. • You will be asked to stay in your room at all times and use your call bell to communicate your needs. • Please leave your car seat in your vehicle. When you have been discharged from the hospital, both you and your baby will be taken downstairs in a wheelchair. While the virus is quite new, as of now there is little evidence that mothers with the virus can pass it to their babies before birth. However, it is possible to expose your baby to the virus after he or she is born. To protect your baby, contact with him may be limited if you are COVID positive or symptomatic, to reduce his risk of contracting the virus. To further protect patients, new mothers will be discharged from the hospital as soon as it is safe to do so, typically 24 hours after a vaginal delivery and two days after a Cesarean delivery. You should discuss any specific concerns that you have with your doctors and caregivers. Becoming a new parent is stressful enough. You should feel safe about delivering your baby at CentraState during—and after—this crisis. Dr. Michael Kirwin, MD, is the chair of obstetrics and gynecology at CentraState Medical Center. He can be reached by calling 866-CENTRA7.

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WE ARE FOLLOWING THE NECESSARY EXTRA SAFETY PRECAUTIONS DURING COVID-19

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We are the only Special Care Nursing Facility in New Jersey to offer intensive therapy on a long term basis for young adults (18-59) with a Neurological Impairment. Horizon’s at Allaire is centered on nurturing independence and optimizing recovery with many individualized activities and programs.

• 174-bed special care neurological unit for patients ages 18-59 suffering from TBI, Multiple Sclerosis, Spinal Injury and other neurological conditions • Technology lab consisting of 25 computer stations with full time assistive technology professional • Neuropsychologist available to talk to patients • 7 day a week therapy • Specially designed activities program with the neuro patient in mind

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SPRING 2020

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Abuse in Later Life Everything You Need To Know About Abuse Later In Life

Abuse in later life and elder abuse are terms used to de- scribe harm to older adults. Abuse in later life and elder abuse can happen to any older adult and can occur in any setting and across all communities and backgrounds. Abuse in later life is physical, sexual, or psychological abuse, neglect, financial exploitation, or stalking of an adult age 50 years or older. In most cases, the victim is in an ongo- ing relationship (such as spouse, partner, family member or caregiver) where society expects there to be a trusting, caring connection. Older victims are from a variety of racial and ethnic groups and all economic levels. Many older victims are active mem- bers of the community. Some older victims are frail and live with significant health issues, physical disabilities, and/or cognitive limitations. Most offenders are spouses, partners, family members, caregivers and other persons in a relationship where the vic- tim and society expect compassion and caring. Sexual assault

or stalking in later life may also be committed by strangers. Strangers may also commit other crimes against older adults, such as scams. In some case, older adults are targeted because of perceived or actual disabilities or vulnerabilities. Most often abuse occurs in the person’s home, which can include private dwellings or facility settings. Some forms of abuse, such as stalking, intimidation, and harassment can also occur in public. Research indicates that power and control dynamics such as found with younger battered women often present in elder abuse cases. Greed is also a motivator in financial exploitation cases. In a small number of cases, well intended caregivers are unable to provide care and an older adult is harmed unintentionally. Also, a small number of abusers cannot control their behavior due to medical or mental health condition that manifests in aggressive, inappropriate, or violent behavior. Theories that elder abuse is caused by caregiver stress, anger, substance abuse, or retaliation for previous child abuse have not been supported by research. Often these issues co-exist with abuse, neglect, or exploitation but do not cause abuse. These problems may need to be dealt with as separate issues. But resolving these problems rarely enhances victim safety or improves the quality of an older victim’s life. There are numerous reasons why victims maintain contact with abusers or feel they cannot leave an abusive relationship. Older victims of abuse often love or care about the people who harm them. Keeping the family together may be very im- portant to the victim for many reasons, including religious and cultural beliefs. Some victims fear that they will be seriously hurt or killed if they leave their abusers. Others do not have the financial resources and/or housing they need to leave. Medical conditions and disabilities may make living on their own difficult or impossible or the abusive individual may need the victims care Help is available. If you are in danger and want law enforcement to respond, call 911. To talk to someone confidentially for support and information, call the National Domestic Violence Hotline at 1-800-799-7233 or TTY 1-800-787- 3224. To find your local sexual abuse victim service program, call the Rape, Abuse, and Incest National Network at 1-800-656-4673 (HOPE). • Remember, you are not alone. Unfortunately, too many women and men are hurt in later life by spouses, part- ners, family members, caregivers, and others. You are not the only one who has experienced harm Disclaimer resource: ncall.us

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Encore Entrepreneurship SENIORS Encore Entrepreneurs are older individuals who have chosen to start their own businesses and enter a new career. This type of Entrepreneur is quickly growing to be the largest group of entre- preneurs in the entire United States. According to Forbes, Americans aged 55-64 start new businesses at a higher rate than any other age group. 23% of new entrepreneurs are over 50 and using the financial security they’ve developed over their careers as well as their experience, passion and expertise to help fund their new small businesses. ...continued on page 20

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SBA.gov has a course available with worksheets to help this demographic with info and advice. This course is designed for individuals planning to start a business after earlier career endeavors. Since encore entrepreneurship is quickly becoming a popular business venture after retirement. The SBA offers online a successful encore entrepreneur plans while these seniors can work diligently to realize their business ownership goal. Visit SBA.gov for info that includes a lot of very useful tools. It also provides a checklist that covers information from their 30-minute online course. The online course and checklist document your thoughts, ideas, and action items you need to do and consider if starting a new career is really what you want. The course is intended to help you document your ideas and possible solutions to common challenges small businesses face daily. You are not alone! If you would like talk to someone about your business, the SBA has a broad network of skilled counselors and business development specialists waiting to help your business start, grow, and succeed.

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Additional Support for Grandparents Raising Grandchildren Grandparents can access a variety of information via the Internet and through state agencies the New Jersey Aging Services, Department of Health and Human Services. For grandparents or for friends, teachers, and social service staff who know of grandparents raising grandchildren, the following information and Internet resources may be of assistance. • National Extension Website for Family Caregiving: http://www.extension.org/family_caregiving. There is a special section on Raising Grandchildren. In addition there is information on the extension website on parenting . • American Association of Retired Persons (AARP): www.aarp.org. ARP provides information on financial assistance for grandparents, becoming the best grandparent, support groups in local communities, and other resources. • Generations United: www.gu.org. This advocacy organization works on family issues across the lifespan. They have a specific link to information on grandparents raising grandchildren. • Children’s Defense Fund: www.childrensdefense.org. The CDF educates the nation about the needs of children and encour- ages preventive investment before they get sick or into trouble, drop out of school, or suffer family breakdown. • CYFERnet: http://www.cyfernet.org/. CYFERnet is designed to be used by anyone who needs comprehensive children, youth, or family information including: educators, researchers, parents, youth agency staff, community members, human services and health care providers, students, policy makers, youth, or media. • Fostering Connections: http://www.fosteringconnections.org/. This site discusses the federal Fostering Connections Act and services. • Grandfamilies State Law and Policy Resource Center: http://www.grandfamilies.org. • This is a website that was developed and maintained by several national organizations. Laws pertaining to grandparent are available from all 50 states. • Grandfamilies of America: http://www.grandfamiliesofamerica.com/. Grandfamilies of America is a national organization that is staffed and governed solely by relative caregivers.

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Addressing Narcissism Narcissist: noun. a person who is overly self-involved, and often vain and selfish. According toWebster, a narcissist at base is characterized as a person who is self absorbed and vain. This is a fine defi- nition, but how does narcissism, considered a type of personality disorder, affect real people in real life who may have real relationships? If someone in your life has the characteristics of a typical narcissist, it may be negatively affecting your life more than you know. Here are signs that someone in your life may be considered a narcissist.

1. They put themselves first. With someone who is narcissistic, you're always going to come second. They're complex is that the world is there to revolve around them, and therefore, you aren't going to be of utmost importance to them, no matter how much they love you. 2. They seem to be inconsiderate of your thoughts and opinions. Again, a narcissist can't agree with anyone else's ideas, be- cause only their own are allowed to be the most important to them. 3. They have wide and fast mood swings . One minute, they can be happy and adoring, but the next, they remember who's sup- posed to the most important person to them, and they switch off. 4. They crave attention and admira- tion, but not just from you. Although you may love and adore this person in your life, that love will never be enough for them unfortunate- ly. A narcissist needs validation from everyone around them that they are important and special. 5. "It's all about me" You may begin to feel neglected. No matter what is happening to you, a narcissist will make you feel as if it is of no importance.

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6. They are self centered, but also altruistic. Because narcissists feel that their opinions are more meaningful than others, they often will try to convince you to follow their rules and take heed of your desires. If this sounds like someone who is close to you in your life, it is important to identify it in order to understand what is really going on. If someone in your life is demoralizing you and leaving you feeling unhappy, narcissism may be the cause. Being in a relationship with a narcissist will never satisfy your needs, only the narcissist in the relationship. With this in mind, take steps to move forwards in your life and keep yourself healthy and happy.

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