15 Ways to Fight Breast Cancer

An estimated 1in 8 women will be afflicted with breast cancer in her lifetime. Although there is no guaranteed protection against the disease, there are things you can do to lower your risk. Follow these tips to help prevent breast cancer and to support finding a cure:

• Maintain a healthy weight.

  There is a strong link between obesity and breast cancer, particularly if extra weight is added after menopause.

• Schedule an annual mammogram.

  This is vital after age 40, as mammograms may help detect early signs of breast cancer, sometimes up to several years before a lump can be felt.

• Eat foods high in fiber.

  Try to consume 20 to 30 grams of fiber daily. Among its many health benefits, fiber may help reduce the amount of circulating estrogen in the body. Foods high in fiber include whole grains and beans.

• Avoid long-term hormone therapy.

  The link between postmenopausal hormone therapy and breast cancer has been a subject of debate for years, and research results have been mixed. For women approaching menopause and having frequent symptoms, experts believe it's probably safe to take hormones for as long as four to five years any longer increases breast cancer risk, without conferring any clear benefits.

• Enjoy soy.

  Isoflavones in soy foods are weak estrogen-like compounds that block the action of estrogen, which may contribute to breast cancer. Use soy flour in recipes, add tofu to soups or main dishes, eat green soybeans, or drink soy milk.

• Limit alcohol consumption.

  Drinking alcoholic beverages is linked to breast cancer, and the type of alcohol doesn't seem to matter. Consume less than one alcoholic beverage per day, or better yet, avoid it entirely.

• Stay physically active.

  Aim for a minimum of 30 minutes of exercise on most days. Try to include weight-bearing exercises, such as walking, jogging, or dancing, which have the added benefit of keeping bones strong.

• Eat good fats.

  Certain types of fats seem to increase estrogen levels, which, in turn, raise breast cancer risk. Opt for monounsaturated oils like olive and canola and omega-3 fatty acids, found in salmon, sardines, and herring. Avoid trans fats, found in stick margarine, packaged baked goods, and snack foods, and the polyunsaturated fats featured in corn, sunflower, and safflower oils.

• Consider aspirin therapy.

  Taking an aspirin just once a week may help protect against breast cancer, but be sure to consult a doctor before starting an aspirin regimen. When used for long periods of time, aspirin can cause stomach irritation, bleeding, and ulcers.

• Avoid additives.

  When possible, buy hormone-free organic meats, poultry, and dairy foods. Be sure to wash fresh produce and remove peels to get rid of pesticide residue.

• Try vitamin E.

  In a small study at State University of New York at Buffalo, participants with a family history of breast cancer had an 80 percent lower risk for developing breast cancer if their diets contained 10 or more IU per day of vitamin E.

• Eat more fruits and vegetables.

  In particular, get enough cruciferous vegetables, such as broccoli, cabbage, and cauliflower, which can boost cancer-fighting enzymes.

• Perform monthly breast self-exams.

  Women can detect lumps or changes in their breasts by performing exams every month. The best time to do a self-exam is a week after the start of your period, when breasts are less likely to be tender or swollen.

• Breastfeed if possible.

  Some studies have shown that breastfeeding may decrease the risk of breast cancer later in life.

• Participate in the fight against breast cancer.

  There are numerous ways to get involved in raising awareness and money for breast cancer research, so do your research and get started today.

6 Ways to Boost Bone Strength

At some point—usually around age 30—everyone's bones begin to get thinner. But only some people will develop osteoporosis, a progressive disease that causes bones to become brittle and more likely to break. 

Your risk for osteoporosis depends on a number of factors, including the thickness of your bones when you were young, as well as the health, diet, and fitness levels you've maintained since. These six tips can help you build bone strength at any age.

• Consume adequate amounts of calcium. 
  

  Adults need 1,000 to 1,200 milligrams of calcium each day, but on average, women get less than half that amount. Excellent sources of calcium include: green leafy vegetables; sardines; calcium-fortified orange juice; and low-fat milk, yogurt, and cheese. Calcium supplements can also be taken to increase calcium intake.

• Limit alcohol consumption.

  Alcohol can interfere with your body's ability to absorb calcium. So remember to drink no more than two alcoholic beverages a day.

• Get B vitamins.
  

  Low B12 levels in the blood signal lower bone-mineral density in men's hips and women's spines, according to researchers at Tufts University. In a Japanese study, high daily doses of B12 (1,500 mcg) and folic acid (5 mg) cut hip fractures by 80 percent in stroke patients.

• Don't smoke.

  When cigarette smoke is inhaled, harmful gases and poisonous substances get mixed into the bloodstream. This automatically affects the flow of oxygen to the blood present in the bones. For that reason, smoking may reduce bone strength, as well as cause back problems.

• Get enough vitamin D.

  Vitamin D helps the body absorb calcium, so it's essential that women consume 400 to 800 international units per day. Vitamin D can be obtained from fortified dairy products, egg yolks, saltwater fish, and liver.

• Exercise on a regular basis.

  Weight-bearing exercises, such as walking, jogging, and climbing stairs, can help build and maintain strong bones. Aim for three to four 30-minute workouts each week. And age shouldn't be a deterrent—it's never too late to start building strong bones.

Adult ADHD Survival Tips

Attention Deficit Hyperactivity Disorder (ADHD) can present any number of challenges for adults, from keeping focused to maintaining healthy relationships. The good news is, there are several steps you can take to make living with ADHD easier. Try the following seven tips to help manage your condition.

Learn about ADHD

There are numerous ADHD resources available, from condition-specific books and magazines to websites and online support groups. Take advantage of these resources, and network with other adults who have ADHD. Once you've learned the basics and established a support system, it becomes easier to work with medical professionals in determining and adhering to the best treatment.

Incorporate structure into your life

For ADHD adults, structure is the foundation for success, so be sure to take advantage of organizational tools such as lists, files, schedules, planners, tape recorders, and PDAs. People with ADHD also tend to be visually oriented, so use color-coding, graphs, charts, and other eye-catching tools whenever possible.

Break large tasks into small chunks

Large tasks tend to overwhelm adults with ADHD, but breaking them down into small pieces makes them easier to manage. For example, instead of, "I need to clean the house today," focus on one particular aspect, such as, "First, I need to straighten up the living room." Focus on completing the first part of the task before moving on to the next.

Schedule personal time

To avoid feeling overwhelmed, it's important to schedule some transitional times between activities. Take at least a 10-minute break after coming home from work to unwind before you start focusing on home life, and set aside a few minutes before or after the morning rush to mentally prepare for the day.

Prioritize responsibilities and obligations

Between work, life, and family obligations, your to-do list can start to seem like a never-ending inventory of all-important tasks and obligations. The key is to take stock, determining which tasks are truly time-sensitive and which others can wait a bit. Remember to tackle the important tasks before you start on something else.

Accept that ADHD may influence your personality

Remember that ADHD is a neurological disorder. Although this doesn't mean that it is an excuse for unacceptable behavior, it can explain certain traits, such as an inability to pay attention, a low tolerance for criticism, and difficulty defining objectives.

Exercise on a regular basis

Exercise is a great way to increase the chemicals in the brain needed for focus and attention. In addition, working out helps to rid your body of excessive energy and promote a sense of calmness and well-being—not to mention enhance your general health.

A Year of Living Less Dangerously

In a perfect world, we'd all know exactly when we need to get our important health screenings. In reality, however, these checkups and exams often take a backseat to work, family, and other obligations.

Fortunately, you can get on the right track by making a simple phone call to your doctor. He or she can recommend self-tests, help you schedule screenings that may uncover health problems early, and make suggestions based on your family history or other risk factors.

For general guidelines relevant to your gender and age group, follow this list compiled by the physicians at Baylor Medical Center at Waxahachie, Texas

Men and Women Under 40

• Blood pressure

  Age 18 and older, every two years if normal.

• Cholesterol

  Starting at age 20, at least every five years.

• Skin cancer

  Adults 20 to 39, every three years. Self-test: Once a month, look over your skin for any changes.

• Diabetes

  Talk to your doctor about including a fasting glucose test as part of your annual physical if you have a family history of diabetes or personal history of gestational diabetes, if you're overweight and don't exercise, or if you're Alaskan Eskimo, Native American, African American, Hispanic, Asian American, or Pacific Islander. Other risk factors include a history of polycystic ovarian syndrome, cardiovascular disease or impaired fasting glucose from previous testing.

Women Under 40

• Breast self-exam

  No one knows your body as well as you do, so check your breasts every month for any abnormalities. Even if you're not sure about what you find, get it checked out anyway just to be on the safe side, says Dr. Jasbir Singh, a Baylor gynecologist.

• Breast exam by a physician

  This should be conducted annually.

• Pap smear

  Annually beginning at age 21 or as soon as sexually active.

Men Under 40

• Testicular self-exam

  Conduct a self-exam once a month, checking each testicle for any lumps or swelling.

Men and Women Over 40

• Continue self-tests and screenings recommended for those under 40.

• Skin cancer

  Get checked by a dermatologist once a year after age 40.

• Colorectal cancer

  Have a sigmoidoscopy with digital rectal exam every five years starting at age 50, or consider a colonoscopy every 10 years starting at age 50. Consider having a fecal occult blood test annually after age 50. The test is linked with a 33 percent reduction in death from colorectal cancer, which is impressive for a test that's very easy to do, says Dr. Jason Nordstrom, a Baylor internist.

Women Over 40

• Clinical breast exam

  This should be conducted by a physician annually after age 40.

• Mammogram

  Annually, starting at age 40. Note: The U.S. Preventive Services Task Force updated its recommendations to state that mammogram screenings be done every 2 years, starting at age 50. Your doctor can assess your screening needs.  

• Bone density scan

  Ask your doctor whether you should have a bone density scan to check for osteoporosis. If you're over 65, you should have your bone density tested.

Men Over 40

• Prostate cancer

  The American Cancer Society recommends a digital rectal exam and a prostate-specific antigen (PSA) blood test annually for men 50 and older. If you're African American and/or have a family history of prostate cancer, you should have a digital exam and PSA annually starting at age 40.

After Dark: Sundowner's Syndrome

When the sun goes down, elderly patients can become irritated, irrational, even violent. The phenomenon, known as sundowning or sundowner's syndrome, refers to the extreme agitation and confusion elderly people may suddenly experience during the late afternoons or early evenings. They can exhibit these symptoms while hospitalized or while being cared for by family members at home.

What Causes Sundowning?

Health experts once thought elderly people suffered from sundowning because they were missing day and night light cues, which disrupted their "body clocks." But modern research blames drug interactions and/or the stress associated with lower brain functions common with dementia and Alzheimer's disease.

In addition, elderly people can lapse into sundowning when daily mental processes, such as thinking and reasoning, reach an overwhelming point late in the day, as if they were experiencing information overload. However, as health experts explain, darkness is a key factor because symptoms usually go away within an hour after dawn and daylight's return.

Some elderly patients may become confused or irritable as a result of the anesthetics used during their surgeries. Others who spend time in intensive care units or are connected to noisy medical equipment may experience "hospital psychosis," which is especially noticeable at night. But hospital psychosis can affect any age group, while sundowner's syndrome strikes only the elderly.

Identifying the Symptoms

Sundowning symptoms vary from person to person, but common signs include:

• rapid mood changes;
• anger;
• crying;
• pacing;
• fear;
• stubbornness;
• restlessness;
• rocking back and forth;
• hallucinations;
• paranoia;
• violence; and
• wandering, especially away from home.

Sufferers may also follow you around as if they're your shadow, doing everything that you do, asking the same questions continuously, or interrupting others. They may grow unable to comprehend abstract thoughts and may even lose their ability to communicate through language.

In addition, studies have shown that those suffering from sundowning experience sleep disturbances caused by physical problems that accompany growing old, such as heart problems, arthritis, "the shakes," restless leg syndrome, depression, indigestion, constipation, and other conditions.

Ways to Cope

When dealing with a loved one who's experiencing sundowning, it's important to remember that patients can't help their symptoms. In fact, they probably won't even remember the episode the next morning when they're more lucid.

Family members may want to stay with sundowning patient throughout the night or at least hire a sitter trained to work with elderly people. Doctors also can prescribe small doses of Haldol, an anti-psychotic drug that has proven effective in calming sundowning symptoms. The following are additional ways to help your loved one:

• Schedule stimulating activities in the mornings.
• Help your loved one to utilize extra energy through exercise during the day.
• Reduce foods and beverages with caffeine, or restrict them to the morning hours to reduce agitation and sleeplessness.
• Provide a completely private area away from visitors and distractions, where your loved one can mentally process information.
• Engage the patient in quiet afternoon or early-evening activities to encourage a better night's sleep.
• Maintain a routine of activities, such as mealtimes, and establish rituals for getting ready for bed, to help your loved one feel safer at night.
• Turn on plenty of lights before the sun goes down.
• Consider putting a night-light in your loved one's room.
• Play soft and relaxing music.
• Suggest another activity the patient enjoys, such as looking at familiar family photos, if he or she starts fixating on something illogical.
• Avoid having visitors, children, or other noisy activities during certain hours of the evening.
• Pay attention to behavior patterns to see which activities trigger sundowning symptoms.
• Check with a doctor to see if your loved ones are suffering a medical ailment, such as arthritis, urinary tract infections, the flu, colds, asthma, allergies and other conditions.
• Use positive instruction, which is easier to remember, rather than telling your loved one what you don't want him or her to do.
• Speak slowly, clearly, and calmly, because matching agitation with agitation will make things worse.
• Install a fence with locked gates if you fear your loved ones will wander. Also, put ID bracelets on their wrists. 

Caregivers' Common Feelings

When you're caring for an elderly loved one, it's normal to feel sad or discouraged from time to time. Ignoring your feelings won't make them go away; in fact, it may even make them grow stronger. Instead, try these six suggestions from the Washington State Department of Social and Health Services.

If you feel sad

Include some pleasant activities in your daily schedule. Listening to your favorite music or spending some time in the garden, for example, can lift your spirits. Even a quick phone call with a supportive friend may be enough to lighten your mood. 

If you feel discouraged 

Remember to take it one day at a time. Try to stay flexible, and accept that there are things you can't change. In addition, make a concerted effort to focus on the positive events and people in your life.

If you feel afraid

Talk to someone about the worst thing that could possibly happen, and plan what you would do step by step. Planning for the future will help reduce your fear of the unknown.

If you feel angry

Take a break, and leave the situation if possible. A quick walk can help defuse your feelings. If you can't leave, stop and take a few deep, deliberate breaths. Focus your anger on the condition, not the person you're caring for.

 
If you feel guilty

Give yourself credit for what you do well. Be realistic about what's possible and what isn't. Focus on one thing you want to do better, and be specific. "If only I could make her eat" won't be as helpful as "I will slow down and make mealtimes more pleasant." 

If you feel overwhelmed

Finally, take care of yourself. Share responsibilities whenever possible, and remember to take a little time for yourself each day. In addition, talk to someone who can help you look at things more objectively, perhaps a friend, a fellow caregiver, or a professional counselor.

Is It Alzheimer's?

If you talked to as many caregivers as I have over the years, you'd know that it's not the least bit unusual for them to wonder, "Is it Alzheimer's or just aging?" This heart-wrenching question hangs over the heads of many, many families for many, many months without ever once being spoken out loud.

Often, it takes one courageous family member to step forward, say it out loud, discuss it with other family members, admit that it is time (or long past time) to make a doctor's appointment for their loved one, pick up the telephone, make the appointment, and take their loved one to find out.

Is It Just Aging?

Many people experience some memory problems as they age. And there are several different conditions that can affect memory, such as thyroid problems, infections, severe dehydration, head injury, and serious depression. Often, the patient's memory improves once the condition that caused the problem is being treated.

However, experts agree that serious memory loss and confusion are not a part of the normal aging process.

Symptoms of Alzheimer's

Alzheimer's is a progressive disease that attacks the brain, causing problems with memory, thinking, and behavior. When you take your loved one to the doctor, he or she will no doubt ask if you're noticing any of the following symptoms in your loved one's behavior:

• Gradual memory loss that affects daily living
• Difficulty performing familiar tasks
• Problems naming common objects
• Getting lost easily, even in familiar places
• Decreased or poor judgment
• Changes in mood, behavior, or personality
• Loss of interest in hobbies

Evaluation and Diagnosis

There's no single test that can determine whether a person has a serious memory problem. A diagnosis is made after a complete medical evaluation, which typically includes:

• Medical and psychological history
• Physical and neurological exam
• A mental status test, to measure the patient's thinking and memory
• Evaluation of ability to perform activities of daily living
• Lab tests
• An interview with a family member

An Alzheimer's diagnosis often brings forth profoundly personal and highly emotional reactions among family members. The key is to be patient with one another and give yourselves time to process it—remember, you don't have to figure out what you're going to do right away.

In addition, learn more about Alzheimer's treatment and care options so you can best meet your loved one's needs as they change over time. Try to remember that the diagnosis is the first step in enabling your family to explore reasonable and realistic treatment and care plans for your loved one.

What You Need to Know About Assisted Living

It's never easy when an aging loved one needs to move to a residential facility. But understanding the basics in advance can help ease the transition when the time comes. As you and your loved one prepare for the future, refer to this Frequently Asked Questions guide provided by the national nonprofit Consumer Consortium on Assisted Living (CCAL).

What Is Assisted Living?

Assisted living is a residential care option for individuals who typically can no longer live independently. It provides or coordinates services to meet residents' individualized needs in ways that promote their independence and reflect their personal choices. 

There are more than 26 designations that states use to refer to what is commonly known as assisted living, and there is no single uniform definition. The definition that CCAL and a large number of national organizations support is as follows: "Assisted living is a state-regulated and -monitored residential long-term-care option. Assisted living provides or coordinates oversight and services to meet the residents' individualized scheduled needs, based on the residents' assessment and service plans and their unscheduled needs as they arise." 

Service provisions must include but are not limited to:

• 24-hour awake staff.
• Provision and oversight of personal and supportive services.
• Health-related services (e.g., medication management services).
• Social services.
• Recreational activities.
• Meals.
• Housekeeping and laundry.
• Transportation.

A resident has the right to make choices and receive services in a manner that promotes dignity, autonomy, independence, and quality of life. These services are disclosed and agreed to in the contract between the provider and resident. Assisted living does not generally provide ongoing, 24-hour skilled nursing care.

How Does Assisted Living Differ from a Skilled Care Facility or Nursing Home?

Assisted living is designed to respond to the needs of individuals who need assistance with activities of daily living such as bathing, dressing, and grooming, but who do not need 24-hour skilled nursing care. Some states require a nurse by regulation in an assisted-living facility, others require round-the-clock nurse availability, and others do not require nursing staff at all. Because the acuity needs of assisted-living residents have increased over the past 10 years, CCAL recommends that a facility have a nurse on staff.

What Does Assisted Living Look Like?

The wide range of assisted-living facilities available doesn't adhere to a single model or design. One facility could be a high-rise building housing several hundred individuals, or it could be a small home with just a few. Living accommodations can include a full-size apartment or a single room. In some facilities, services are limited to meal preparation, housekeeping, medication reminders, and minimal assistance. In others, more intensive services, including help with administering medications, on-site nurses, and regular assistance with daily activities such as bathing and dressing are available.

How Can I Identify a Good Assisted-Living Facility?

Regardless of the size or look of the facility, the foundation of a quality assisted living residence lies in its philosophy, practices, administration, and staff. You want to be sure that the administration's philosophy and practices are truly resident-centered. You also want to know that they have well-trained, qualified direct care staff and have sufficient numbers of them to meet residents' promised and unscheduled or emergency needs. The environment should be warm and inviting, with administrators, staff, residents, and family members interacting in a caring, respectful manner. For more information on choosing a facility, check out the CCAL's Choosing an Assisted Living Facility: Considerations for Making the Right Decision.

What Types of Services Are Offered?

There's wide range in terms of the scope of services and care provided by assisted-living facilities. Many states set a threshold level of care need beyond which individuals can no longer stay in assisted living. Facilities can choose to provide any range of services up to this threshold. Some facilities, for example, may choose to discharge a resident that becomes incontinent. Research shows that the major reason people leave assisted living is to receive a higher level of care. It is difficult to relocate, so you may want to consider a facility that offers a high range of care and services to begin with.

Who Lives in Assisted-Living Residences?

There are approximately 1 million assisted-living residents living in more than 36,000 facilities nationwide. The majority of individuals move into assisted living because of a significant change in health condition. Approximately two-thirds of residents come to assisted living from home. The rest come from hospitals, nursing homes, and other assisted-living facilities.

What Are the Costs/Fees?

Approximately 90 percent of individuals pay for assisted living out-of-pocket or through other private funding. Monthly payments can range from $3,100 to $6,000 and up, depending on geographic location, unit size, and services provided. Shared units, if available, generally cost less.

Is Assisted Living Covered by Medicare, Other Government Programs, or Private Insurance?

Medicare, the federal health insurance program for older individuals, does not cover assisted living. Forty-one states currently use Medicaid waiver monies for some low-income individuals to support assisted-living expenses, but the majority of assisted living is private pay. Increasingly, long-term-care insurance policies include coverage for assisted living. There have been some payment issues from insurance companies for residents in states that do not have an appropriate assisted-living licensing process. Be sure to check the status of your state. 

The Consumer Consortium on Assisted Living educates consumers, trains professionals, and advocates for assisted-living issues. It is currently the only national consumer education and advocacy organization focused on the needs, rights, and protection of assisted-living consumers, their caregivers, and their loved ones.