Princeton's Ask the Doctor November-December 2019

Ask The Doctor is the Princeton area’s only magazine that only contains editorial regarding health and wellness.

The Greater Princeton Area Ask The DOCTOR The Health &Wellness Magazine For You And Your Family HOLIDAY ISSUE NOVEMBER/DECEMBER 2019

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 ...

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QUESTION: I have beenwanting to try CBD. I’ma little nervous to do it but I see it sold everywhere. From the gas station to the supermarket I see signs, “CBD sold here!!!” How do I go about finding a safe and high-quality product? ANSWER: “CBDproducts” are amixture of cannabidiols and other compounds from the hemp plant, Cannabis. Hemp plant products contain extremely low levels of THC and do not produce a “high”. In 2018, the US Farm Bill made hemp-derived CBD products legal at the federal level. People are using CBD for depression, insomnia, anxiety, pain, migraines, arthritis, and nausea. Research has shown it is effective for reducing inflammation and pain, modulating the immune system, enhancingmood, protecting the brain, and improving libido. It is being studied for its use in supporting opioidwithdrawal. But how can you be a wise consumer when both the FDA and a recent JAMA article have shown that many CBD products are not true to their label? When buying a CBD product you should be guided by a knowledgeable expert. You should ask for a Certificate of Analysis showing the components of the product as tested by an independent third-party lab. You should look for a USDA Certified Organic label. You will want a product that has been extracted by Super Critical CO2, not chemically extracted. It should be chemical, solvent, herbicide and pesticide free. It should be distilled for purity, odor and bioavailability. Full spectrum hemp products have shown better health benefits than the CBD isolate products. 252 W. Delaware Ave Pennington, NJ 08534 E E • N O W A C C E P T I N G A P P L I C A T I O N S • S C H Y F E E • N O W A C C E P T I N G A P P L I C A T I O N S • S C T R Y F E E • N O W A C C E P T I N G A P P L I C A T I O N S • E N T R Y F E E • N O W A C E P T I N G A P P L I C A T I O ST. MARY’S WINTER SPECIAL Move in b for January 1, 2019 and get the 2nd month fr e! You will need to understand the dose you will be taking because the labels are confusing. The amount of CBD inmg on the front of the product label is usually the amount in the entire product. You need to divide that by the number of servings in the product AND understand what the product considers a serving (5 drops? 1 dropperful?...). And, after all that, be sure to start with a low dose and increase slowly with each successive dose until you achieve the effect you are looking for. CBD can interfere with some medications and there is some evidence that high doses can affect the liver in some people. It is best to let your health care provider know you are taking CBD so that the proper surveillance can be achieved. Most of all, do your homework. Choose your products wisely. 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. Our Continuum of Care Com Our Continuum of Care Co Our Continuum of Care Our Continuum of Car T. MARY’S WINTER SPECIAL Mov in before January 1, 2019 and get the 2nd m nth fre ! Campus shared with St. Lawr Campus shared with St. Lawre Ready to take t THE GREEN HOUSE® APPROACHTO N Meaningful Life • Real Home • THE GREEN HOUSE® APPROACHTO Mea ingful Life • Real Home TH GREEN HOUSE® APPROACH Meaningful Lif • Real Ho THE GREEN HOUSE® APPROAC Meaningful Lif • Real Morris Hall Se Campus shared with St. Lawrence Rehabilitation Center READY TO TAKE THE NEXT STEP?

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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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Why Headaches Happen and How Chiropractic Can Help Most headaches are tied directly to tension in the neck and upper back. Tension can be caused by sitting at a desk all day, physical or emotional stress, or poor diet and dehydration. Muscle tightness in this area can affect the position of the vertebrae, which can then cause nerve irritation. Because these nerves are connected to the head, you end up with a headache. A chiropractic evaluation will determine where the tension is, where the nerve irritation is, and where the vertebrae is out of line. A chiropractic adjustment, electric muscle stimulation, and other techniques can realign the spinal joints, loosen the muscles, and relieve stress and pressure. Allergy and sinus headaches are both caused by inflammation. With a food allergy, substances might not be digested properly in the liver, causing inflammation. An environmental allergy, where the body is unable to process toxins or allergens, can cause inflammation. A sinus headache is caused by fluid buildup in the nasal cavities in the skull. If your body can’t break down that fluid, it can cause inflammation and pressure. There are chiropractic techniques that target specific pressure points and reduce inflammation that causes headaches. Realigning the spine can improve how the brain communicates with the rest of the body so it can process allergens effectively. Even the bones of the skull can be gently manipulated to relieve pressure and restore balance. Beyond chiropractic techniques that align the spine and loosen themuscles, a chiropractor can recommend exercises, stretches, ergonomic improvements, and changes in diet. These recommendations can help you avoid recurring tension and inflammation, resulting in fewer headaches. Of course, the worst thing you can do is ignore headaches or dismiss them as normal. Pain is your body’s built-in alarm system that warns you when something isn’t quite right. If you experience headaches on a regular basis, call to schedule an appointment at In Good Hands Chiropractic Center. Allison J. Scharf, DC

IN GOOD HANDS CHIROPRACTIC CENTER, LLC • 609-924-9331 330 N. Harrison Street, Suite 6 • Princeton, NJ 08540

QUESTION: What’s new in dentistry today?

For many years dentists would promote their practices as “Cosmetic Dentistry”. To many, the term cosmetic dentistry would mean the use of veneers to make the front teeth look whiter and healthier, or the use of composite restorations instead of the silver, amalgam fillings. Today, when the term “cosmetic” is used, it also needs to include “facial esthetics”. It is not correct to separate the teeth and their appearance, from the smile or even the rest of the face. The entire facial structure needs to be evaluated when you want to achieve that perfect smile.

David P. Young, DMD, DICOI Unfortunately, as we age, changes occur not only to our teeth and gums, but also the muscles of the face. As these muscles relax, facial tone and fullness diminish and wrinkles develop. To achieve optimal esthetic goals this needs to be addressed as well, not only the broken yellow front teeth. With the use of Botox and Dermal Fillers, a more youthful beauty can be restored to your face and your new smile will radiate even better. Millions of people use Botox and Dermal fillers to achieve a more relaxed and smooth facial appearance, while still having the freedom of expression. Not only is Botox used for esthetic purposes, it is very helpful for people who suffer from TMJ syndrome, chronic migraine headaches, and other types of facial pain. Botox is an FDA approved purified protein which is injected into targeted muscles and temporarily blocks signals that cause muscle movement, essentially relaxing the muscle which reduces or eliminates fine lines and wrinkles. An attractive smile can significantly improve your image and self-confidence. Total facial esthetics will bring out your full beauty potential. For further information on Facial Esthetics and Cosmetic Dentistry, feel free to contact my office for a consultation. Your smile is not limited to how good your teeth look, it’s how you radiate with total facial beauty.

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

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NOVEMBER/DECEMBER 2019

The Benefits of Carrot Oil By Pam Teel

Carrot oil is procured from carrots grated and boiled in regular oil. Carrot seed oil is extracted through steam distillation from the dried seeds of carrot. Carrot oil is very effective for the human body owing to its antibacterial and healing powers. Carrot oil is capable of hydrating dry skin, scalp, and hair and can be used alone or with a carrier oil. Carrot seed oil is used as a lubricant for the outermost layer of the human skin. This oil is capable of infusing into the skin to restore the lost moisture, which happens due to evaporation. It forms a protective coating on the skin and hair helping them to retain their natural moisture levels. Carrot oil is also used in many commercial moisturizers. Carrot oil helps in softening the skin tissues. It is highly beneficial for the treatment of skin eczema and other skin problems. Carrot oil infuses moisture and provides essential antioxidants to the skin when applied topically. Both, carrot root carrier oil and carrot seed oil have beneficial properties. Both the oils help in soothing the dry or irritated skin and help in cell-regeneration like soothing wrinkles and stretch marks. Using a lot of carrot oil as a topical application can give you an orangish hue on your skin, and that is why the commercial products contain carrot oil in small proportions only. To procure carrot oil, the common carrot, scientifically known as Daucas Carota is used. The dried seeds of carrots are steam distilled to extract the oil. Carrot root oil is extracted from the carrot plant's fresh roots. Both are used in skin care and hair care. Carrot essential oil is not fatty oil like canola or olive oil. It is instead, a very concentrated liquid containing fragrant properties and the therapeutic goodness of the carrot plant including its leaves, flowers, seeds, and stems. Skincare formulas instruct us to use carrot oil only in small drops rather than adding them in ounces because they are highly potent. Carrot oil is rich in vitamins and a very effective moisturizer. It can be used as an all-purpose skin cream that helps in soothing wrinkles, dry skin, rashes, and swelling. It is typically dark yellow in color and carries a rich fragrance of earth and wood. The carrot carrier oil is used in larger proportions than essential oils. Carrot root carrier oil is a superb moisturizing base for dry skin prod- ucts. This carrier oil contains beta-carotene, vitamin A, and other essential minerals. It has a reddish hue and is very fragrant. It is generally blended with milder products like olive oil or other such oils when used in skin care products. When blended with other oils, carrot root oil should not be added more than 20% to the other carrier oil. The ratio of carrot root oil to carrier oil should be 20:80. Even carrot seed oil works best when blended with other oils. The general benefits of carrot oil for the human body: Antifungal properties - Carrot oil has strong antifungal properties owing to the presence of carotene sesquiterpenes carotol, daucol and beta caryophyleine. Skin Anti-oxidant -Carrot oil contains high levels of vitamin A, powerful antioxidants and carotenoids. It also has high levels of tocopherol which is a fat-soluble Vitamin E. The anti-oxidants present in carrot oil protect the skin and promote skin healing with the help of skin regen- eration. It stimulates the skin cells and is also used in many skin creams due to its rejuvenating properties. Perfume Ingredient -Carrot seed oil is very concentrated and has a naturally sweet scent. It is used as a combination with other scents and highly used as an essential oil in aromatherapy products. It is also used in the manufacturing of various perfumes. Nutriceutical Plant - Carrot oil is known as a strong nutriceutical product owing to its various medical and health benefits. It is helpful in healing the body and protecting it against various diseases. Carrot oil is power-packed with vitamins C, A and E. All these are essential vita- mins which protect the body from illnesses. Carrot oil has powerful anti-inflammatory effects and is used to treat orchitis, which is a type of swelling and inflammation in the testes. Carrot oil is a powerhouse of vitamins A and E which are highly beneficial for the hair. These vitamins help in hair growth and they are also helpful in preventing hair loss. Regular use of carrot oil helps in strengthening the hair and makes it shinier. Carrot oil is an excellent moistur- izer for the skin and hair. It Helps in promoting hair growth, renders the hair smooth, shiny and soft, stimulates the blood circulation in the scalp, strengthens the hair follicles and hair roots, protects the hair against environmental damage such as sunlight, pollution, etc. In order to get the maximum benefits from carrot oil in the hair, a hair mask can be made. Carrot oil has plenty of benefits for the skin such as skin lightening, skin rejuvenation and prevention of wrinkles. It is used in the formulation of many skin care products. Carrot oil is very beneficial for adding moisture to the skin and gives antioxidant protection. Both carrot seed oil and carrot root oil is helpful in preventing wrinkles and stretch marks. Carrot oil is loaded with nutrients which heal the skin and prevent the skin from further damage. Although highly beneficial, there is some caution to be followed while using carrot oil. Carrot oil should be avoided by pregnant women. It is not good for the health of the child and the mother both. People suffering from asthma or epilepsy should also avoid using carrot oil. Over usage of carrot oil has shown some case of headaches and vomiting and hence one must avoid over usage. Always apply carrot seed oil on your skin after mixing it with carrier oil as this oil alone can give an orangish hue to your skin. Do not go out in the sun after application of carrot seed oil or cover up your body if you must go out. Also, do a skin patch test before applying carrot oil all over your body to check for any possible irritations. There are plenty of companies selling carrot oil these days, just look on Amazon. While some of them manufacture carrot oil in a pure and organic way, there are some which sell chemical-induced carrot oil. Organic carrot oil will have a natural scent and earthy flavor. With just a few days of regular use, you will know the difference in your skin, and hair.

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OUR DEPARTMENTS As We Age ............................................................ 11 Articles and physician information just for seniors Kids’ Health & Camp ..........................................22 Information, news and expert advice to raising healthy children from pregnancy to 18 Financial Health ................................................29 Information, resources and news related to the health and well-being of your financial future I Am Beautiful .....................................................36 The Healthy Palate .............................................38 Recipes to enjoy and local dining options for eating out Healthy Home .................................................... 44 Here you will find expert tips to make your home healthier, safe and fabulous Men’s Health .......................................................52 Expert tips for Men’s health and fitness Doctor Profiles ...................................................... 56 Physician information, including credentials, to help you choose a doctor or find out more about a doctor that you go to now Healthy Mind & Soul ..........................................58 Inspirational stories and advice on achieving mental balance and clarity

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What?! Why would a DENTIST be asking me about my Sleeping Habits or Sleep Apnea? The dentist may be the first person who sees that you may be at risk for Sleep Apnea—specifically, Obstructive Sleep Apnea (OSA). What is Obstructive Sleep Apnea? (OSA) - OSA is a medical condition where your airway collapses or is obstructed while you are asleep. Result: you do not get adequate oxygen in your blood, and to your brain. It is measured by the average number of times you either stop breathing (apnea for 10+ seconds!) or have inade- quate oxygen uptake (under 50%) during breathing per hour while you are asleep. This Apnea plus hypopnea index (AHI)- measures the severity of sleep apnea. Over 5 episodes per hour is by definition Obstructive Sleep Apnea, with over 30 episodes per hour being severe Sleep Apnea! Why is this even important? Besides being tired and fatigued, and being at higher risk for a car accident, and possibly snoring and having a disturbed nights sleep for you and your partner and …Untreated OSA is known to significantly increase your risk of high blood pressure, heart disease, chronic fatigue, GERD, stroke, diabetes, cancer, depression, Atrial Fibrillation, mental fogginess and dementia! While you are sleeping if you have OSA, your body struggles for oxygen and leaves behind tell- tale signs. During the routine Oral Cancer screening, the dentist will see these signs that correlate with OSA: • Scalloped Sides of Tongue Indicative of Clenching • Enlarged Tongue • Small Natural Airway and /or Retruded Lower Jaw • Swollen or Elongated Uvula • Enlarged Tonsils If you are looking for a dentist and team that truly cares about your total health – give us a a call today! 609.921.7744 • www.deciccodental.com • 67 Tamarack Circle, Skillman NJ 08858 • Heightened Gag Reflex • Tooth Cracking and Chipping from Bruxism and/or Clenching • Cheek Abrasions from Bruxism • Dry Mouth Dr. Mary DeCicco

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NOVEMBER/DECEMBER 2019

Cold Temperature Good for Our Health? We all on the East Coast know that the cold weather is on its way. But, did you know that the cold temperatures benefit your health? Colder temperatures may help reduce allergies and in- flammation and research has shown that it does help us think more clearly and perform daily tasks more efficiently. Another surprising fact is when it's cold, your body has to work harder to maintain its core body temperature — and as a result, we burn more calories. The cold can also help lower the risk of some diseases. Mosquitoes that carry diseases such as Zika, West Nile Vi- rus and Malaria are not around during the winter season.

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Dry January: The Pros

According to a 2018 study by the Substance Abuse and Mental Health Services Administration (SAMHSA), over 14.4 million Americans have an alcohol use dis- order. Of those, 10.6 million were ages 26 or older, but 3.4 million were between the ages of 18 and 25. While there have been reductions in youths ages 12-17 who initiated substance use, alcohol addiction remains a prolific problem in the United States. In about 11.5 percent of cases, people with a substance use disorder struggle with addiction to both alcohol and illicit drugs. Dry January is an annual ritual of alcohol abstinence started by the British char- ity Alcohol Concern in 2013. The organization became alarmed that 31 percent of men and 16 percent of women in England were consuming more than the recom- mended limit of 14 units of alcohol in a single week.

Many people who decide to abstain from alcohol for the month find the task simple because many of them do not struggle with alcohol addiction. Conversely, there have been several studies that do show positive benefits. Cutting alcohol from your diet can result in several physical, mental, emotional and social health benefits. These benefits include: Weight loss: Alcohol contains a varying number of calories. By abstaining from alcohol use, you can reduce your calorie intake and lose weight. The website Drinkaware allows people to calculate the number of calories in several types of alcohol. Better sleep: Multiple reports, including one by the University of Michigan, indicate that reducing your alcohol intake can result in better sleep. Alcohol is known to affect sleep patterns. Disrupted sleep can lead to low energy levels and endurance. Improved organ functioning: A study by University College London found that avoiding alcohol intake for a month can reduce liver fat by 15 percent. Fat around the liver can damage cells, cause inflammation and lead to other functioning issues. Clearer mind: Reducing your drinking can help your cognition. Sobriety can assist you with thinking more clearly, which increases your likelihood of performing well at school, home and work. Enhances relationships: In addition to affecting a person’s physical health, alcohol can harm their relationships. The substance can cause people to act erratically or in ways in which they normally would not act. Sobriety can make people calmer and more easily approachable. This could help maintain current and forge new relationships. A study of 857 Dry January participants was published in the journal Health Psychology. The study followed up with partic- ipants at one and six months, concluding that there were positive impacts from giving up alcohol for a short period. Roughly 50 percent of the group ended up drinking less overall. However, 10 percent had a rebound effect and drank more than before the period of abstinence.

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NOVEMBER/DECEMBER 2019

Did you know that falls are the most common cause of fatal and non-fatal injuries in the elderly? And colder weather brings sluggish joints and less blood flow to the body and the brain. This leads to slower reaction times and more unsteadiness. 1 out of 4 people aged over 65 falls every year. Over 3 million injuries are treated annually in the ER. Over 55 billion dollars are spent on treating the elderly due to falls, of which Medicare and Medicaid shoulder 75% of the cost. Not only is the fall a disastrous event, the after effects of depression, physical decline, feeling of helplessness, and isolation all are very common. This also leads to increased stress for the family or immediate caretaker.

Your podiatrist, Dr. Sanjay Gandhi , is an active participant in the National Fall Prevention Program. This includes a podiatric and gait examination to check for risk factors of falling. If you qualify, you are entitled to balance braces that keep your legs from “wobbling” or “teetering”. You also may be able to get free shoes that provide the proper support and grip to maintain ground reactivity. Preventing falls is essential to keeping those minor bumps and bruises away, but also to preventing major head injuries that can cause bleeding and sometimes permanent damage. If you are over 65, and feeling even the slightest bit unsteady, get screened properly today! You have nothing to lose and everything to gain. A Step Up Podiatry

Dr. Sanjay Gandhi, DPM Our Specialty Services For Adults, Children & Seniors Bunions Children Corns & Callouses Diabetic Foot Care Flatfeet Fungus HammerToeTreatment Heel Pain InGrownToeNails Plantar FasciitisTreatment Plantar Warts Orthotics and Surgery

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Teen Privacy- Balance Is The Key By Stefanie Maglio

Teenagers will almost always fight for free- dom in the form of privacy from their siblings and parents. This is where parents may struggle to find the right balance of privacy they allow their teen to have. Many factors can come into play while navigating through this situation. For example, a parent knows their kid best. Do they have a history of making good choices and obey- ing rules? Or have your children demonstrated a history of untrustworthiness?

Trust is a majorly important quality to have in a parent-teenager relationship. The more trust the parent has in the child, the more privacy that is likely to be given. When kids are in their younger teen years, it is okay to be a bit more strict with rules such as monitoring social media and what programs they're watching. However, if the child shows responsibility and capability of handling more privacy, it is okay for the parent to be a bit more lenient and let go even more so. It's truly about finding the perfect balance. A parent shouldn't let go of the reigns too soon, as their child may make dangerous decisions that could threaten their health or future. However, it is also not good for the parent to let go too late, such as being too intrusive without reason. This can dis- empower the child. Most importantly, there should always be an open, caring, and safe dialogue between the child and parent. Honesty is key. It is all about give and take. The teen will earn more privacy as they prove they are responsible and trustworthy. Once they prove to do otherwise, some privacy may be revoked. Remember that it's all about doing what is best for your individ- ual teenager, as they are all unique and different.

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Second Hand Drinking and Its Effects on Others By Pam Teel We’ve all been victims or we know others who have felt the bad effects of someone’s excessive drinking habits. Whether it be a child, a neighbor, a friend, or even yourself, you know the toll this abusive behavior can take on you and how it could affect the people around you. Secondhand drinking (SHD) is a term to describe the negative impacts of a person’s drinking behaviors on others. It can cause significant harm to a person’s physical and emotional health and well-being, as well as the quality of their life. Drinking behaviors are not intentional; rather they are what happens when alcohol changes the way a person’s brain works. It is unlikely most of us have ever encountered the term, Secondhand Drinking (SHD), although we may draw a comparison to that of Secondhand Smoke. Yet, secondhand drinking can forever alter people’s lives. We generally do not think much about what happens to people whose paths cross with those of a person who misuses alcohol beyond the obvious, such as an auto accident caused by a drunk driver. An accident can affect everyone involved and we’re not just talking about those who were at the scene but the impact on every family member, friend, and also members of a community as well. We all know drinking and driving doesn’t mix and we probably all have a horror story or two of a friend or someone in town that was badly injured or killed in a drunk driving incident. Think about how it affected you and how it affected the family of the victims. According to the National Highway Traffic Safety Administration, every two minutes, a person is injured in a drunk driving crash. Drink- ing affects judgment, depth perception and physical reaction time. The effects of a split second decision cannot be reversed. Driving under the influence puts all lives at risk, not just the life of the driver. Passengers place trust in all drivers on the road. Bikers, pedestrians, children crossing roads, pets chasing a ball, even people enjoying the outdoors in the safety of their property are at risk of being a victim of a careless drunk driver. Careless decisions can erase all the boundaries that protect us. The cost of a DUI resonates years beyond the incident. Fines are the immediate impact, and insurance premiums increase for the long term. Job opportunities can be lost years after a drunk driving incident occurs. Credit reports can be impacted. These costs are tied only to a drunk driving arrest. Next are the rehabilitation costs such as treatment. Finally, an accident or loss of life that results from a drunk driver can lead to endless financial consequences. The legal fees, the cost of repairs to property and the liability paid out to victims can paralyze individuals and their families. Distress from drunk driving remains with victims, families, and the accused for months or years following an incident that may have lasted only minutes or seconds. Sudden physical impairment or unexpected death is traumatic. Few people can cope with these losses even with a strong support system and professional resources. Grief, depression, anxiety, and many other emotions can impact someone affected by drunk driving. Split second decisions to drive can lead to life altering events and unimaginable consequences. Guilt can overcome convicted drunk drivers while anger may harvest within victims or their families. There is no permanent remedy that heals feelings of loss and safety. The emotional impact remains forever. The effects of drunk driving can cause a ripple in so many lives. Approximately 90 million Americans experience secondhand drinking. They include spouses, children, parents, co-workers, in-laws, class- mates and friends. They are the people affected by drinking behaviors, whether it is verbal, physical or emotional abuse, driving while im- paired, or sexual assault. It is estimated that two to three times that number of people are indirectly affected by secondhand drinking. This is typically the ripple effect of someone’s drinking behaviors or someone’s secondhand drinking experiences. These people are often the in-laws, friends of friends, co-workers, children and fellow classmates, and even the citizens of a community. A new study finds the effects of "secondhand" alcohol harms are widespread, with nearly 1 in 5 Americans -- 53 million people -- reporting having been harmed by someone else's drinking during the past year. Those harms include threats or harassment, damaged property, van- dalism, physical aggression, financial problems, relationship issues and issues related to driving. Heavy drinkers should be aware of how they might be impacting the lives of people around them. Boston Medical Center's Timothy Naimi raises a critical eye to alcohol's effects, discussing the importance of recognizing what freedom actually entails. "The freedom to drink alcohol must be counter-balanced by the freedom from being afflicted by others' drinking in ways manifested by homicide, alcohol-related sexual assault, car crashes, domestic abuse, lost household wages, and child neglect." Naimi writes that the secondhand effects of alcohol have been underreported; they need to be considered when deciding on alcohol control policies. He calls for "structural, environmental interventions" to reduce excessive drinking, especially in light of the fact that 40 percent of alcohol-re- lated deaths are not the drinker's. He proposes increasing taxation on alcoholic products, which has been shown to reduce over-drinking. Sven Andréasson, a Stockholm-based doctor, offers an even more aggressive second commentary. He notes that many nations legislate specifically to reduce the secondhand effects of drinking, not only in traffic laws, but also through the enforcement of tough domestic and neglected child policies. He finds it unthinkable that some countries still use .08 percent blood concentration level as the legal designation for being drunk when that number results in a far higher death rate than the .05 percent limit other countries enforce. Control policies, such as alcohol pricing, taxation, reduced availability, and restricting advertising, may be the most effective ways to reduce not only alcohol con- sumption but also alcohol's harm to persons other than the drinker. More steps need to be taken to prevent long-term impact in anyone’s life when it comes to driving under the influence: designate a driver, have taxi numbers and trusted friends’ numbers on hand, and most importantly, hand over your keys. Protect yourself and the lives of your friends and family. Drink responsibly. Stay sober. Don’t drink and drive. It’s not just your life you will affect. Think of all the others who will suffer!

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ADVICE FOR THE AGING COMMUNITY Gratitude is Defined as the Quality of Being Grateful By: Linda Mundie How can you start living with more gratitude? First, make it a point to be more aware of what you have. Take an inventory of even the smallest things in your life that you are grateful for. Think of something you might take for granted—the dinner on your plate every night, a warm place to live, the telephone that keeps you in touch with your daughter who lives in Arizona. Bringing awareness to and acknowledging what we do have helps us live in gratitude. Keeping a gratitude journal is an easy exercise. Every night, before you turn in for the night, think of three things that you have to be thankful for. They may be big things, like an unexpected visit from a loved one, or small things, like a bird that came to your bird feeder today. Write them in a journal or notebook before you go to sleep. In one study, a group of people was asked to practice this gratitude exercise every day for one week. Even though the exercise lasted for only seven days, when measured a month lat- er, participants were happier and less depressed than they’d been at baseline, and they also stayed happier and less depressed at the three- and six-month follow-ups. The benefits of practicing gratitude are nearly endless. People who regu- larly practice gratitude by taking time to notice and reflect upon the things they’re thankful for experience more positive emotions, feel more alive, sleep better, express more compassion and kindness, and even have stron- ger immune systems. Here are a few ways to help not only to start a gratitude practice, but to maintain it for the long haul. First, get real about your gratitude practice. Being excited about the benefits of gratitude can be a great thing because it gives us the kick we need to start making changes. When we want to achieve a goal, using the technique of mental contrasting—being optimistic about the benefits of a new habit while also being realistic about how dif- ficult building the habit may be – leads us to exert more effort. Recognize and plan for the obstacles that may get in the way. For instance, if you tend to be exhausted at night, accept that it might not be the best time to focus for a few extra minutes and schedule your gratitude in the morning instead. Don’t limit yourself—if journaling is feeling stale, try out new and creative ways to track your grateful moments. Create a gratitude jar this year. Any time you experience a moment of gratitude write it on a piece of paper and put it in a jar. On New Year’s Eve, empty the jar and review everything you wrote. You just might find that when a good thing happens, you will think, “That’s one for the gratitude jar!” It can make the moment more meaningful and keeps us on the lookout for more.

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A Talk with An Elder Driver The population of people age 65 and older is the fastest growing demographic in the United States. Many of these older adults will be drivers. Right now, there are more than 30 million licensed drivers age 65 or older. People between ages 25 and 75 have relatively low crash involvement. After age 75, risk increases because motorists may have health conditions or take medications that negatively affect their driving abilities. Drivers may be unaware of these changes or unwilling to admit challenges to themselves or others, including family mem- bers. In the case of people with cognitive impairments, like dementia, they may be unable to recognize poor performance. Many family members and caregivers wonder what to do when they think a loved one’s driving skills have diminished. Or, they may not know how to assess one’s driving abilities. They may dread approaching an older adult to discuss the need to modify driving habits or stop driving. Older adults and their loved ones and caregivers should take a realistic, ongoing inventory of the driver’s skills and openly discuss them. Family members need to remember that many older drivers view driving as a form of independence. Bringing up the subject can make some people defensive, angry, hurt, or withdrawn. Be prepared with observations and questions, listen with an open mind, and be ready to offer transportation alternatives. You may need to talk with an older driver if you answer “yes” to any of the following questions. • Does he or she get lost on routes that should be familiar? • Is he or she overwhelmed by road signs, signals, markings, or other things while driving? • Does he or she take any medication that might affect the capacity to drive safely? • Does he or she stop inappropriately or drive too slowly, preventing the safe flow of traffic? • Does he or she suffer from Alzheimer’s disease, dementia, glaucoma, cataracts, arthritis, Parkinson’s disease, diabetes, or another condition that may affect driving skills? If you need to start a conversation about driving safety, it is important to be caring, respectful, and non-confrontational. Show genuine concern and understanding and offer alternatives that will not injure the older driver’s self-respect and sense of independence. You might also consider riding with an older driver to observe, encouraging a vision and hearing evalu- ation, or suggesting a driving safety class. You and/or the older driver can also discuss concerns with a physician, who may have recommendations. The good news is that, depending on the severity of the problem, older drivers may be able to adjust their driving habits to increase safety. For example, they may limit driving to daylight hours and good weather or avoid highways and high-traffic areas. National Highway Traffic Safety Administration | 1-888-327-4236 • Have you noticed new dents, scratches, or other damage to his or her vehicle? • Has he or she been warned or ticketed by a police officer for poor driving? • Has he or she experienced a close call or crash recently? • Has a doctor advised him or her to limit or stop driving for health reasons?

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Malnutrition As You Age You may experience malnutrition as you age if you are not able to eat well-balanced, nutritious foods. Malnutrition is not tied to your weight. So, whether you are underweight, overweight, or obese, you may still be malnourished, and your health and well- being may decline. Fortunately, Older Americans Act (OAA) nutrition assistance programs offer well-balanced, nutritious meals, which may help you reduce your health risks. With age you may experience malnutrition due to: • Decrease in appetite • Decreased ability to process food • Problems with chewing and swallowing • Oral health problems with your teeth and gums • Problems with mobility and vision that create difficulty shopping for or preparing food • Medications taken for chronic illness that can cause poor digestion or appetite, and affect your nutrition needs • Diseases that cause problems with thinking, learning, and remembering or your emotions, like Alzheimer’s disease and depression. They may prevent you from organizing meals or wanting to eat. Malnutrition can cause you to have: • Difficulty with learning, thinking, and remembering • Loss of muscle and bone • More infections, illness, and falls • Poor quality of life Research shows that nutrition services can improve your health, function, and quality of life. Experts recommend a year- ly nutrition screening when you have no functional problems. If you receive services and supports to remain at home, you may need screening four times a year.

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Seniors are working past age 65 and employers are looking for a way to provide affordable health care coverage to a diverse population of staff. OBJECTIVE: Creating healthcare benefits that covers a diverse workforce requires a cohesive strategy. Wages and benefits make up an employee’s compensation package - the key is to find an affordable and cohesive balance that is both attractive to top talent and is sustainable for your business. STRATEGY: Benefits with a Cohensive Balance

INCENTIVE: Federal tax laws contain certain incentives for employers to offer a selection of before-tax benefits that allows individual employees to enhance core benefit/compensation plans; byway of “cafeteria” plans, which can be offered at no additional cost to the business owner. Cafeteria andMedicare supplemental plans help to create a cohesive cost-saving balance that attracts and retains quality employees.

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Employers should recognize the business value of a healthy workforce and encourage employees to take control of their health. • Developing or enhancing a workplace culture where employees are responsible

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