Princeton's Ask The Doctor March-April 2019

The Greater Princeton Area Ask The DOCTOR The Health &Wellness Magazine For You And Your Family EARLY SPRING ISSUE MARCH/APRIL 2019

Local Physicians Answer Your Health Questions

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

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Hackensack Meridian Health Carrier Clinic

CONTACT INFORMATION HACKENSACKMERIDIAN HEALTH CARRIER CLINIC

252 County Road 601 Belle Mead, NJ 08502 800-933-3579 communityrelations@carrierclinic.com carrierclinic.org • Accreditation or licensing: Accredited by Joint Commission, Member of New Jersey Hospital Association, New Jersey Association of Mental Health and Addiction Agencies, American Hospital Association and National Association of Psychiatric Health Systems • Accepts insurance: Yes • Addiction treatments: Inpatient: Yes • Adolescent services: Inpatient: Yes (starting at age 12) • Detox programs: Inpatient: Yes • Number of beds: more than 200 • Patient-to-counselor ratio: Team approach • Type of support services available for families: Weekend Codependency Program, Bright Futures for Kids, Parents Support Group, Al-Anon Meetings, Mood Disorder Support Group • Additional services: Free confidential anxiety, depression and alcohol dependency screenings

Emotional Harmony Hackensack Meridian Health welcomes Carrier Clinic to the family!

A new day in behavioral health is dawning with Carrier Clinic, now part of the Hackensack Meridian Health network. Two of the most accomplished health care providers, both with more than a century of service to New Jersey and the region, are now becoming one! Our shared mission is to pave the way to acceptance and understanding of behavioral and mental health issues, improve access to care in local communities, pioneer innovations in care, and create pathways to emotional harmony. Learn more at HackensackMeridianHealth.org .

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ASK THE DOCTOR

MARCH/APRIL 2019

QUESTION: When I smile, I show a lot of “gum tissue”. What can be done to improve my smile? This condition is what dentists call the “gummy smile” There are different causes for this condition, such as osseous (bone) conditions, excessive gingival tissue (gum tissue) covering the teeth, and or excessive muscle action. It is important to understand that this is not a pathological condition, but for many it is an esthetic concern. Prior to treating, a thorough examination should be performed followed by an accurate diagnosis.

David P. Young, DMD, DICOI

Treatment for this condition can vary depending upon the patients long and short term goals. In some cases treatment can include oral surgery, orthodontics, or periodontal treatment. In addition to the above mentioned invasive procedures, the use of “Botox” can be utilized to relax a group of muscles thus allowing the upper lip to be slightly relaxed and then allowing it to cover the excessive gingival tissue. One of the biggest advantages to the use of Botox is the ease and convenience. The results are quite esthetically pleasing and you do not need to undergo extensive oral surgery or orthodontics. The disadvantage is that Botox lasts about 3-4 months and then needs to be re-injected. The administration of Botox takes no more than 10 minutes and the effects are noticed within a short period of time. The use of Botox is a fabulous alternative to surgery for many people. It may be the answer that you may be looking for. If you have or know someone that has a gummy smile, let them consider a consultation with me to see if this conservative procedure can address their concerns.

4432 Route 27, CN-201, Kingston, NJ 08528 Phone: 609.497.0808 www.David YoungDMD.com

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Allergies, Sensitivities, Imbalances, Oh My! The Answer Isn’t Always Cut and Dry. ll i , I ’ l You’ve heard of gluten, the protein found in wheat, rye, barley and other grains that acts as the glue that holds certain foods together and helps them maintain their shape. And you’ve probably heard of celiac disease, an autoimmune disorder that causes damage to the small intestine when gluten is eaten. Symptoms include diarrhea, abdominal pain, bloating and weight loss, but celiac disease can also lead to skin rashes, infertility, nerve damage and bone weakness. But you may not have heard of gluten sensitivity/intolerance, where celiac disease may not show up in a blood test, yet you don’t feel right after eating gluten. After a few hours or even days, you might experience headaches, brain fog, joint pain or numbness. However, damage to the small intestine is minimal. An allergy is an immune response to a food, chemical or environmental substance. Allergic reactions can vary from person to person. An imbalance can occur when energy channels in the body become blocked. This affects your ability to break down, absorb and remove a substance from the body, which makes it difficult to function at an optimal level. In other words, you develop a sensitivity to the substance because your body’s energy is out of sync. The worse the imbalance gets, the more sensitive you become. Perhaps the liver isn’t filtering substances properly. The problem might not be liver disease or an allergy, but an energy imbalance. Most people assume that if they’re allergic or sensitive to a substance, they have no other recourse but to avoid those substances or deal with the consequences. That’s not true. In fact, restoring energy balance in the body could be as simple as reprogramming how the brain responds to certain allergens so the body can function properly. In the next article, I’ll introduce you to Nambudripad’s Allergy Elimination Technique (NAET), a drug-free, non-invasive approach to diagnosing and addressing sensitivities, imbalances and allergies. IN GOOD HANDS CHIROPRACTIC CENTER, LLC • 609-924-9331 330 N. Harrison Street, Suite 6 • Princeton, NJ 08540 Allison J. Scharf, DC

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QUESTION: What Is Oxidative Stress? I’ve heard it is bad for you. ANSWER:

252 W. Delaware Ave Pennington, NJ 08534

InFunctionalMedicinewemeasure oxidative stress because it is themajormechanismthat causes disease. It is the cause of heart disease, cancer, diabetes, immune dysregulation and aging. We are always trying to decrease the oxidative stress in the cells because it leads to inflammation in the tissues and diseases in the body. Oxidative stress is the result of an imbalance between free radicals and antioxidants. Free radical compounds attackmolecules in your cells and antioxidant molecules neutralize and clear the free radicals. We are always exposed to free radicals. We produce free radicals just by breathing and eating to make energy in our cells. Environmental toxins, processed foods, excessive exercise can increase our free radical burden. These free radicals steal electrons from other molecules, turning them into yet more unstable free radicals. This process will destroy our cells unless it is stopped. The way to stop free radical attack is to neutralize them with antioxidants. Antioxidants like CoQ10, glutathione, carnitine and melatonin are made in your body. Vitamin C, Vitamin E and many flavinoid compounds found in plants like citrus fruits, apples, grapes, onions, spices, and green tea are examples of the abundance of antioxidants we can get fromour diets and dietary supplements. Eating plentiful amounts of brightly colored fruits and vegetables containing antioxidants can lower the burden of free radicals and lower the oxidative stress.

Oxidative stress can be estimated by taking a breath test, a urine test (lipid peroxides and 8-OhdG), a blood test (glutathione, sulfate) and a stool test (Calprotectin). If it is elevated, it is important to find the cause. Oftentimes it is occult infection (from unsuspected oral infection or from leaky gut). It could be the result of high blood sugar, food additives and preservatives, environmental pollutants and toxin exposure, high body fat and elevated stress. The treatment is to decrease exposure to free radicals and to increase protection through antioxidants - - and live a longer, healthier life!!!!! Dr Kate Thomsen’s office for holistic health care is located in Pennington, NJ. She is trained in Family Medicine, and Board Certified in Integrative Medicine, and is an Institute for Functional Medicine Certified Practitioner. She has been practicing Functional Medicine for 20 years. For more information see www.drkatethomsen.com or call the office at 609-818-9700.

FAMILY GENERAL DENTIST

666 Plainsboro Rd., Suite 645 • Plainsboro, NJ 609-275-0022 • Drpaterson@comcast.net www.plainsborodentalarts.com ALL ages, and ALL aspects of dentistry! INCLUDING COSMETIC AND IMPLANT DENTISTRY

Peter Paterson, DMD Kimberly Minassian, DMD Ariane Seto, DMD

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MARCH/APRIL 2019

Battling Back: Early Physical Therapy Intervention Improves Low Back Pain—and Reduces Costs By Brian Mason, PT, DPT If you’re suffering from low back pain and are putting off clinical treatment, you may experience more pain—and higher medical costs—in the future. Approximately 80 percent of adults experience low back pain at some point in their lives, according to the National Institute of Neurological Disorders and Stroke. The condition is the most common cause of job-related disability and a leading cause of missed work days. A recent research study found that patients who were referred to a physical therapist within two weeks of seeing their primary care physicians used fewer medical resources and paid lower health care costs than those who delayed treatment. Specifically, those who underwent physical therapy had a reduced risk of needing surgery, injections, additional physician visits, opioids, and advanced imaging studies. In fact, health care costs for patients receiving early care from a physical therapist were significantly lower, on average. In short, the data shows that the sooner a patient starts physical therapy, the faster they recover, which ultimately saves them money. What Causes Low Back Pain? If trauma, such as a car accident, isn’t the cause, low back pain most often develops due to mechanical stresses over a long period of time. This can be from sitting too much, improper lifting techniques, poor posture, poor strength conditioning and/or poor core strength. The condition can occur at any age. While the average age of those needing spine surgery in the United States is age 40, more children are experiencing back pain than in previous generations because they are sitting more and moving less, and many are looking at devices for prolonged periods of time. To determine the cause of pain, a practitioner will look at a patient’s medical history and perform a physical exam, and may order tests. I have found that if I listen to my patients, they will explain what they are experiencing in detail, enabling me to make a more accurate diagnosis. When Should I Seek Treatment? Patients need to start active recovery as soon as possible. This means that after a day or two of limiting your activity, you should take action to return to your previous level of function. If you haven’t returned to normal in two weeks, you should seek clinical intervention. The first step is to find a practitioner like a physical therapist who understands active recovery, bed rest, and modalities such as traction, massage, electrical stimulation, manipulation, and pain medications. These are short-term treatments that can relive pain. In New Jersey, patients can access physical therapy services without a physician referral. How Can Physical Therapy Help? Severe low back pain is very painful, and more importantly, it can be scary for patients. Often, when I see patients in the emergency department, their fears about the condition are nearly as important to address as the physical pain and reduced mobility that they are experiencing. It’s important that I help each patient overcome their fear of physical activity to pre- vent it from impacting the rehabilitation process. The goals of physical therapy are to: • Minimize distress • Restore function quickly • Encourage patients to be active participants in their recovery • Educate patients about their specific injuries and how to avoid reinjury • Develop a recovery program that patients can continue after therapy • Reduce the need for opioid pain medications, which rarely improve healing For example, if I see a patient who has low back pain that’s so severe that they have trouble bending at the waist, I’ll develop a therapy program that’s designed to empower the patient to address underlying factors that contributed to the condition. The most important thing to remember is that if you are experiencing low back pain, the sooner you take steps to recov- er, the quicker you can resume doing the things you love, and avoid more expensive, invasive treatment down the road. Brian Mason, PT, DPT, is the clinical director of Rehabilitation Services at CentraState Medical Center. He can be reached by calling 866-CENTRA7.

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OUR DEPARTMENTS Health Articles and Q&A Pages ............................ 5 Your questions answered from local physicians, medical news and information As We Age ..............................................................12 Articles and physician information just for seniors Kids’ Health & Camp ............................................ 22 Information, news and expert advice to raising healthy children from pregnancy to 18 Men’s Health .........................................................30 Expert tips for Men’s health and fitness The Healthy Palate ............................................... 33 Recipes to enjoy and local dining options for eating out Healthy Home ....................................................... 39 Here you will find expert tips to make your home healthier, safe and fabulous Healthy Mind & Soul ............................................50 Inspirational stories and advice on achieving mental balance and clarity Financial Health .................................................. 53 Information, resources and news related to the health and well-being of your financial future I Am Beautiful ....................................................... 62 Everything from tips to trends Where to go in NJ for specialty services Diet & Fitness ........................................................66

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Synthetic cannabinoids: What are they? What are their effects? By Cassandra Mayall

H E A L T H A R T I C L E S A N D Q & A

Synthetic cannabinoids (“synthetic marijuana,” “Spice,” “K2”) are various manmade chemicals that some people may use as an alternative to marijuana. These seemingly inno- cent little packages of “fake weed” can cause serious side effects that are very different from those of marijuana. Synthetic cannabinoid products can be toxic. As a result, people who smoke these prod- ucts can react with rapid heart rate, vomiting, agitation, confusion, and hallucinations. Some have to get help from emergency medical services or in hospital emergency depart- ments or intensive care units. Synthetic cannabinoids are not one drug. Hundreds of different synthetic cannabinoid chemicals are manufactured and sold. New ones with unknown health risks become avail- able each year. Synthetic cannabinoids are popular because users often believe they are legal and relatively safe. These chemicals are called cannabinoids because they act on the same brain cell recep-

tors as tetrahydrocannabinol (THC), the main active ingredient in marijuana. However, the hundreds of known synthetic cannabinoid chemicals and THC are different chemicals. In fact, synthetic cannabinoids may affect the brain in different and unpredictable ways compared to marijuana. Synthetic cannabinoids are used in a variety of ways: • Sprayed onto plant material and smoked • Mixed into a liquid and vaped in electronic nicotine delivery devices (such as e-cigarettes) • Added to herbal tea or to food and swallowed Consumers can buy synthetic cannabinoids in convenience stores, from individual drug dealers, or online as incense or natural herbal products. They are sold under a number of brand names, including • K2 • Spice • AK-47 • Mr. Happy There are no standards for making, packaging, or selling synthetic cannabinoid chemicals. That means that two packets of a brand-named product may have completely different chemicals. Synthetic cannabinoids can affect brain function. Signs and symptoms and health problems include: • Agitation and irritability • Confusion and concentration problems • Hallucinations, delusions, psychosis, suicidal thoughts, and violent behavior • Seizures • Sleepiness and dizziness • Breathing problems • Gastrointestinal problems • Heart attack, fast heart rate, high blood pressure, and stroke • Kidney failure • Muscle damage These health problems depend on many factors, including the specific synthetic cannabinoid, the dose (how much), and the duration of use (for how long). The long-term effects of long-term synthetic cannabinoid use are unknown. Synthetic cannabinoids may be addictive, since some people have reported withdrawal symptoms after heavy use over a long time. Experts think that the severity of these symptoms is related to how much synthetic cannabinoid is used and for how long. If you or anyone you know becomes sick after using synthetic cannabinoids, seek immediate medical attention. Call 911 or go to the closest emergency room. If you have questions about synthetic cannabinoids, including whether or not to go to the emergency room, please call your healthcare professional or contact your local poison center by calling 1 800 222 1222. • Scooby Snax • Kush • Kronic

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Grieving Elderly and the Immune System By Susan Heckler

Any type of loss or trauma throws your entire life into a tailspin. The loss of a loved one can particularly impact your emotional and physical health. When you are under stress, ever notice a change in your blood pressure? It also throws off your cholester- ol levels, brain chemistry, blood sugar levels, and hor- monal balance. Stress plays a major role in your immune system. Our bodies have a delicate balance of two stress hormones, cortisol and dehydroepiandrosterone sulphate (DHEAS). While the stress hormone cortisol is known to suppress the immune system, DHEAS enhances it, so maintaining a relatively balanced ratio helps to keep your immune system functioning properly. New research shows that the elderly are more prone to a weakened immune system while grieving. They are more likely to develop infections than the younger people due to the hormonal imbalance. Studies noted illness-fighting white blood cells were reduced among the older bereaved study participants. By age 30, the amount of DHEAS we produce starts to decline, with elderly having about 20% of the DHEAS they had in their youth. Grief is also associated with chronic diseases like ulcer- ative colitis, rheumatoid arthritis, asthma, heart disease, and cancer. This is due, at least in part, to chronically ele- vated cortisol. Researchers found that losing a significant person in your life raises your risk of having a heart attack the next day by 21 times, and in the following week by 6 times. "Broken Heart Syndrome" is basically a "tempo- rary" heart attack that occurs due to stress. This diminish- es after about a month. Sedentary behavior is linked to a 25 percent greater probability of being depressed compared to those who are active. This is true whether or not you’re grieving. It is un- certain which comes first, the depression or the inactivity, as one leads to the other in either direction. Activity trig- gers a number of neurotransmitters, such as endorphins, serotonin, dopamine, glutamate, and GABA. These are well-known for their role in mood control. In many cases, being physically active may alleviate the need for anti-de- pressants. During your time of crisis, pay careful attention to the elders and watch for warning signs.

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An aging population, that is augmented by chronic disease, and an increasing physician acceptance of home care is fueling the growth of care for seniors. The key focus is to solve one of the biggest health care and economic challenges of our time “Who will take care of our aging population, and how?” Our answer, we complete the need in the Care Management space by equipping and enabling family members, care givers and health care professionals with the right training and tools, they can dramatically lower the overall cost of care, reduce hospital admissions and re-admissions, and bend the cost curve of aging. Our Solution is on the lines of private duty care management. It is catered to manage “Care in Place” not only for our elderly population, but also any demography with disorder or Chronic Disease that one wants to manage. We provide state of art technical solutions where the heart of processing lies in our proprietary Rule Engine. In the Rule Engine you can define rules for chronic disease like Dementia, Alzheimer’s, etc., or even simple aging issues. You can also set up rules for a Special Child or Special Adult to manage them properly in their surroundings, with care as the focal point. The system is shipped with Activity of Daily Living (ADL and iADL) rules and with basic templates for Dementia, Autism to name a few, that can be extended to suit the need of each individual. Monika Sinha, co-founder of WeCare Health System says, “Our goal is to provide a one stop shop in the Care Management space, specially in the ‘Care-In-Place’ sphere since, it is not only the life expectancy that has increased over the past decade, but also because people prefer to get care in a familiar surrounding.” OUR VISION Our vision is to provide for the “To Be Cared” population, a best in class technical solution that will assist with caring of population who want care in familiar surroundings. OUR MISSION Our mission is to use technology to strengthen the continuum of care, to reduce costs and to improve outcomes by enabling family members, care givers and health care professionals to monitor and manage care that is to be provided. OUR SOLUTION Presenting “myCareportal” - Your In-Home Care Station. Key features are listed below. Let WeCare Health System’s solutions propel your organization above and ahead of the competition by utilizing our easy to use and affordable Technical Solution.

H E A L T H A R T I C L E S A N D Q & A

• Template based Rule engine • The CareGiver Portal can be installed on any portable Android device • Caregiver Clock In/Out

WeCare Health System also supplies a special ‘CAREGIVER KIT’ for caregivers reaching out to help people, you can order it online at: https://supplies. wecareportal.com

• Incident Capture • Task Management • Access from any Device

• Admin Portal • Family Portal • Provider Portal • Initiate and Manage Move Movement for Seniors • Initiate and Manage Home Modification for Seniors

myCarePortal Mobile Application 200 Buckelew Avenue, 2nd Floor Suite #6, Jamesburg NJ • info@wecareportal.com Call us at: +(888)310-6109 or Monika Sinha, Cofounder 732-910-7829 WWW.WECAREPORTAL.COM

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MARCH/APRIL 2019

KNEE PAIN Dr. Scott Paris

H E A L T H A R T I C L E S A N D Q & A

QUESTION: What’s the best way to treat knee arthritis? Consider a non-surgical treatment that really works!

O s teoarthritis of the knee is the #1 leading cause of disability in the U.S. Over 27 million people suffer with knee arthritis and that number continues to grow. With knee arthritis, the cartilage breaks down and wears away, leaving the bones to rub together causing pain swelling stiffness and limited range of motion. As the cartilage breaks down, the knee loses its lubricating fluid. We found that by replacing this lubricating fluid with a natural substance called Hyalgan, the lubrication is restored and many patients experience amazing pain relief.

DOES IT HURT? Many of our patients report that they feel little to no pain at all!We do everything possible to minimize any pain from the procedure, from pain relieving spray and a local anesthetic, to precision guidance that ensures we are always in the right spot. WILL MY INSURANCE COVER HYALGAN? This procedure is covered by most major insurance companies including Medicare. Our insurance department pre-verifies every patient. WHO WILL BE PERFORMING THE HYALGAN PROCEDURE? Dr. Scot Paris is the medical physician who performs the Hyalgan injection. Dr. Paris is trained as a general surgeon and has extensive experience with a variety of surgical procedures. With his conservative approach, he has excelled in the non-surgical treatment of knee pain with the use of fluoroscopy guided Hyalgan injections. SO HOW DO I KNOW IF YOUR KNEE PAIN TREATMENT PROGRAM WILL HELP ME? If you are tired of suffering with painful arthritis of the knee, and you want to see if the latest advances in non-surgical treatment can help, all you have to do is call 732-683-1800 to set up a risk free consultation. During the

WHAT IS HYALGAN AND HOW DOES IT WORK? Hyalgan is a natural lubricating fluid that acts as a lubricant and shock absorber inside the knee joint. The substance in Hyalgan is hyularonic acidwhich is normally found in high levels in healthy joints. Replacing the hyularonic acid with Hyalgan lubricates the joint and reduces pain. Hyalgan has been administered over 40 million times and has been proven to provide long-lasting relief of knee pain from osteoarthritis. WHAT IF YOU ALREADY TRIED KNEE INJECTIONS? If you have had injections like this in the past and experienced poor results, there is still hope! Many doctors in this area offer similar injections, but very few use precision fluoroscopy guidance. Fluoroscopy guidance ensures that the pain relieving Hyalgan reaches the knee capsule where it bonds with the joint fluid to create a lubricating and cushioning layer. Without fluoroscopy, it is estimated that doctors “miss” the capsule over 30%of the time resulting in poor results. We want each and every one of our patients to have the greatest chance of success, so every injection is done with precision fluoroscopy guidance to ensure that the Hyalgan gets into the capsule 100%of the time. Because of this, patientswho previously felt little to no relief with non-flouroscopy guided injection are now getting excellent results. The other “big difference” in our results is the multitude of other supportive care options that we have available to enhance the effectiveness of the Hyalgan procedure. These options include state of the art medical laser treatment, physical therapy, manipulation, corrective osteoarthritis bracing (takes pressure off the damaged section of the knee), and natural anti-inflammatory products. The combination of these treatments offers you what we feel is the most comprehensive non-surgical knee treatment program available.

consultation all of your questions will be answered in a warm and friendly environment. Knee replacement surgery is a very extreme measure to take without considering all of your other options first. Once it’s done there is no turning back. For that reason we encourage you to schedule an appointment to see if you are a candidate for Hyalgan treatment.

We are proud to offer our patients a comprehensive knee pain treatment program that includes the best non- surgical methods to relieve pain all under one roof. We look forward to having the opportunity to help you feel better. Take the first step in ending your knee pain and call to schedule an appointment today!

Dr. Scott Paris using precision fluoroscopy guidance to ensure the best results possible.

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A S W E A G E

“There Is No Place Like Home”

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Amazing Grace

By Linda McAndrew RN, BSN • Director of Nursing In both the Christian and Jewish religion, Easter and Passover are considered to be two of the most important holidays of the year. Both of

these holidays signify hope and transformation and both play an important part in family life. How can we help seniors with dementia become more involved in the blessings of the season?

Anyone who has a loved one suffering from dementia or Alzheimer’s knows that the disease can be isolating because of the manifestations of the symptoms. These symptoms include memory loss, anxiety, and a decrease involvement in life in general. How better to help these wonderful seniors than to engage them in the many activities associated with both Easter and Passover. Here are several activities that may help. One activity that can help with both memory and anxiety is to make lavender Easter sachets. The sachet pouches are created by filling premade fabric squares with lavender seeds and then sewing or gluing the open end closed after it is filled. This activity can be easily done with the entire family involved. Lavender can decrease anxiety and also help with memory. Because the aroma or smell of the lavender enters through the nose, it transmits signals to the hippocampus which is closely related to memory and emotions. An Easter egg hunt is another way to help Alzheimer’s or dementia family members enjoy both filling and hiding eggs for younger children to find. Have plastic Easter eggs filled with various fun items including jelly beans candy and other Easter symbols. After the eggs are filled, help the senior hide the eggs in preselected places for the hunt. This activity will serve the purpose of involving everyone in the activity and can help the senior remember family activities from days gone by. An activity that can involve all members of a family for Passover is the creation of a Blessing Bag. With many people standing on street corners and highway exits, the creation of Blessing Bags can be used as an activity for Alzheimer’s seniors and also to help those less fortunate than ourselves. Most Blessing Bags are filled with a variety of helpful things that can be easily gotten at a Dollar store. The following are suggestions for the contents of the Blessing Bag: 24 count zip lock baggies (to be used as the Blessing Bag), Personal Care items such a socks, toothpaste, tissues, lip balm, band aids, a packet of analgesics; Shelf-stable food items such as a protein bar that’s both crunchy and salty, fresh fruit; Printed items such as coupons for free meals, names, addresses, and phone numbers of local food pantries; Seasonal items such as hand warmers. By helping seniors with dementia create Blessing Bags they are helping to create hope for those in need. Easter and Passover helps all of us remember that we all have a place in God’s plan in these seasons of hope and transformation. Happy Easter and Passover to all.

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A S W E A G E

A dedicated and loyal staff with over 200 years of experience. Stop by for a visit and meet our devoted Care Team at The Chelsea at Manalapan! 732-972-6200

445 Route 9 South Manalapan, NJ 07726

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QUESTION: What is the difference between a Medicare Beneficiaries Hospital Admission and Hospital Observation? ANSWER: Admission vs. observation can have a major impact on the out of pocket cost for care. Prior to the Affordable Care Act hospitals were not held accountable for the number of readmissions that occurred within a 30 day period, which factored in driving up the cost of healthcare. The ACA now emphasizes “performance”, hospitals are now rated by the effectiveness of their treatments and readmissions are considered incompetent. As a result, hospitals are more careful about admitting people.

Valerie Mathis-Leake CLTC, CBC, AHIP Founder, Our Fight For Life

• Medicare beneficiaries are sometime unknowingly entering hospital as observation patients, which is considered outpatient by CMS. • You should receive a Medicare outpatient Observation Notice (MOON) that will inform you if your services are outpatient. • Observation services can be costly. Your total copayment for all outpatient services, under observation, could be more than your inpatient hospital deductible. • Observation services are hospital outpatient services such as testing you receive while your doctor concludes supporting and/ or medically necessary documentation to admit or discharge you. • Observation services can also be facilitated in the emergency room as well as other departments with in a hospital and it could result in an overnight stay. It is important to know, if you are receiving outpatient observation services for more than 24 hours.

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A Summary of Brain Games for the Elderly By Katie Greene Whenever the topic of brain training games comes up, particularly to combat the onset of aging-related dementia, we like to point to this well-researched article. It contains a wealth of information, and a large list of games and activities that are truly beneficial in brain training. However, it is a rather lengthy read, so in this article we are going to summarize its’ more salient points. Brain Training Circumvents, Not Prevents, Dementia

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It’s well known that there is no known cure for Alzhei- mer’s, but it is entirely possible that dementia symptoms can be circumvented. This is not the same as preven- tion - it is rather a method of redirecting information through your brain, so that information avoids travers- ing damaged neural pathways. Imagine your brain as a map of roads, forming bil- lions of intersections. What dementia does is damage the intersections, preventing information from flow- ing freely throughout the brain. This can affect your speech, memories, and job performance. While seniors were expected to retire by 65 in previous generations, modern lifespan has increased the work and retirement age. What brain training is believed to do is form new intersections (neural synapses), which information can take as alternative routes. As long as you are constantly training your brain and learning new information, you are forming new neural synapses. continued on pg. 15

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continued from pg. 14

New Information Matters Most The important part is learning new information. It’s been proven that memory-based games that rely on recalling pat- terns, or simple mathematics and word problems, don’t form any new neural synapses. Yes, it’s “brain training”, but it's the equivalent of bicep curls with 10lb weights. You do not form new neural synapses by recalling information you already know, just like you don’t build new muscle with weights that are too light for you. Thus, the best type of brain training is when you actively pursue new knowledge. Learning a new language, for exam- ple, has tremendous benefits. You are rewiring your brain in a new way to communicate. Learning history, science, a musical instrument - anything where your brain processes new information is the secret to true brain training. While you don’t necessarily need games to learn history, games make learning more fun. When you’re having fun, you’re more engaged in the activity. That is why brain train- ing games are recommended. So to summarize, things like memory games, Crossword puzzles, and anything that involves information you already know, is not ideal brain training. Those activities may help you awaken your brain for the day, but you must actively pursue new knowledge to truly counter the onset of demen- tia. For a much deeper explanation with plenty of links to proper brain-training games, you can consult the article we linked at the beginning of this one.

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609.448.7036 Call our admissions team today to schedule a tour! Post-Hospitalization Rehabilitation Personalized, Goal-Oriented Treatment Physical Therapy • Occupational Therapy Speech Therapy • 24-Hour Nursing Staff Certified Dietitian • Long-Term Care Respite Care • Hospice & Palliative Care Religious Services • Kosher Kitchen Medicare, Medicaid and most insurances accepted • Lon • Res Nur The

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