salud+health info magazine

Salud+HEALTHinfo.com ISSUE # 48 VOL. 13 2015


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Everyone is at risk when temperaturesrise above 90 degrees but the elderly,the very young and people undercertain medical conditions are most sus-ceptible to heat and heat-relatedillnesses. An electric fan can help, but itcan't take the place of an air conditioner.

The Cool Zone program began in 2001after an unusually hot summer causedenergy blackouts and higher utilitycosts. Since then, every summer, theCounty designates Cool Zone sites allover San Diego, airconditioned settingswhere seniors and others can gather.

The Cool Zone sites encourage peopleto share air conditioning during the heatof the day to protect their health, andreduce their individual energy costs.Cool Zone sites are helping to conserveenergy for the whole community andalso are great places to meet peopleand socialize.

To locate a Cool Zone near you, visitwww.CoolZones. org or call the AIS CallCenter at (800) 510-2020 and press 6.

The County Cool Zones

are officially open.

IN THIS ISSUE

Contact us:

SALUD+HEALTH INFO is designed for informative and educational pur-poses only. You should not rely on this information as a substitute forpersonal medical attention, diagnosis or hands-on treatment. If you areconcerned about your health or that of a child,please consult yourfamilys physician or health provider immediately and do not try to diag-nose yourself.

SALUD+HEALTH INFO is published and distributed free of charge by IONPublishing Co. All rights reserved. ION Reserves the right to edit all information provided tothe publisher as it deems necessary with regard to all legal, public health , State,Federal, International and other standards for the proper publishing of this periodical. We re-serve the right to refuse any article and advertising at any time . No reproduction of thismagazine by any means is permitted without the written consent of ION PublishingCompany. ION has no affiliation with any health organization or political group. ION is notresponsable for the claims of advertisers, not for the verity of submitted written articles.

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SUMMER 2015

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Prevent, Protect and Report

Stages of heat related illness

Protect you child as much as possible

Tips to strech your food dollars

The anti-aging powers of exercise

Cardio workout in your chair

Do you have a loved one livingin an assisted living facility?

HEALTH infoSALUD

2 Salud+HEALTHinfo.com ISSUE # 48 VOL. 13 2015

When the temperature rises, nothing beats a sweet,juicy piece of fruit or the crisp crunch of a fresh

14veggie. What a wonderfulway to quench thirst!

Continued on page


The earthquake disaster movie San Andreas isfeaturing over-the-top destruction and larger-than-life heroism; even though, Hollywood fantasy is notCalifornia reality. The earthquakes in the movie arefar larger than can ever happen in California.However, there are many earthquake prepared-ness elements that the film gets right.

1.Hollywood fantasy is not California reality. Still,the San Andreas and other major faults in Califor-nia can rupture in large, damaging earthquakes atany time. Fortunately, there is still much that wecan do now to be prepared in order to minimizedamage and expedite recovery.

2. The San Andreas fault is not long or deep enoughto have a magnitude 9 or larger earthquakeas depicted in the movie. The largest historicalearthquake on the northern San Andreas was the1906 magnitude 7.9 earthquake. In 1857 the FortComputer models showed that the San Andreasfault is capable of producing earthquakes up toabout magnitude 8.3, but anything larger isextremely unlikely. Shaking from even the largestpossible San Andreas fault events will not be felton the east coast.

3.Faults do not split apart during earthquakes asshown in the movie. The ground on the two sidesof the fault slide past each other, they do not pullapart. Narrow crevices may form due to bends inthe fault or in regions with very strong shaking.

4.The San Andreas Fault cannot create a big tsu-nami, as depicted in the movie. While a part of thefault near and north of San Francisco is offshore,the blocks on either side of the fault slide past eachother horizontally; this will not cause significant ver-tical motion of the ocean floor that pushes up wa-ter, as need to cause a damaging tsunami. Local

The San Andreas Movie

FICTION or

REALITY?

Be Disaster Prepared, Be Disaster Aware, andTake Action Before can Happen.

For San Diego it is a Reminder to be Prepared

CONTINUED on PAGE 30

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Emergencies can happen at any time and place,but practicing what to do in advance of anemergency makes you better prepared to handleany emergency you may encounter.

tsunamis might be generated along the California coast,if the shaking from an earthquake on the San AndreasFault triggers underwater landslides or if there is a slipon a smaller offshore fault. In contrast, the CascadiaSubduction Zone, north of the San Andreas Fault sys-tem does generate very large earthquakes that havecaused large tsunamis.

5.The heros recognition of the onset of a tsunami-eventwas portrayed well. Water levels do sometimes drop/retreat prior to the arrival of a tsunami and it is impor-tant to take action and seek safety after recognizingthese signs. Vertical evacuation, as shown in the film isa good response. Many of the characteristics of the tsu-nami...


EMERGENCY PREPAREDNESS AND

YOUR

Include the following items, asappropriate, in your emergency supply kit:

You should also includeimportant medical-relateddocuments such as:

With a few simple steps, you can be sure your mostimportant medical needs are met during an emergency.

Whether you live independently, with family membersor friends, now is the perfect time to develop or reviewyour disaster plan, and put together an emergency sup-ply kit that includes the items necessary to meet all ofyour medical needs. During an emergency, the medi-cines and devices you depend on daily will be crucial toyour health and safety.

List of all medications, including aspirin or non-aspirin painreliever. Equipment and supplies necessary for your medications,i.e. alcohol wipes, syringes, test equipment, ice or othercoolants for medications that require lower temperatures. Medicines such as anti-diarrhea medication, antacid forupset stomach, laxatives, childrens medications, etc. List of make, style and serial numbers of medical devicessuch as pacemakers,pumps, monitors and accommodationdevices. Be sure to pack extra batteries. First aid kit that includes bandages and gauzes, safety pins,cleaning agent, latex gloves, sunscreen, scissors, sewingneedle(s), adhesive tape, tweezers, moistened towelettes,antiseptic, rubbing alcohol, thermometer, tongue depressors,petroleum jelly or other lubricant, medicine dropper, etc.

Hearing and vision aids are alsoimportant to have in youremergency supply kit, including:

Talk with your health careprovider and pharmacistabout receiving emergencymedication supplies. Under afederally declared emergency, youcan get an extra 30-day supply withno price increase, even for recentlyfilled prescriptions.

Spare prescription glasses and contactlenses, even if they are not your latestprescription. Dont forget cleaningsolution. Sunglasses both prescription and non-prescription. Spare hearing aids, even if they arenot your latest prescription, and extra bat-teries.

Doctors and pharmacys contactinformation. Health insurance information, i.e.policyand claim numbers. Blood type and any allergies. Medical history and current conditions. Copies of prescriptions for medicationsand required doses. Documents identifying any disability or ac-cess and functional needs.

Make these documents portable forevacuation by scanning and saving themon a thumb drive or create a notebook, andthen store in a waterproof bag or container.

Emergency Preparedness is not just for the young,especially when it involves specific health andmedical needs. Pregnant ladies, mothers with littleones, elders and people with any kind of medicalneeds are the one who need to be prepared themost for any type of emergency, with thoughtfulplanning and coordination with family,friends,healthproviders and caregivers ahead of time. Their lifeand safety will deepnd on it.

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HEALTH


Keep the curtains or the shut-ters closed. Keeping the sunfrom streaming directly in helpskeep your place a little cooler.

Wet towels if you need to cool allof your body and wrap your legs,torso and arms with them.The reason this remedy works isbecause your wrist and neckboth contain pulse points.Studies show that this will reduceyour core body tempera-ture.The relief is almost immedi-ate.

Eat cold meals. Just as drink-ing a nice cold drink cools yourbody, eating cold food helps keepyour internal temperature loweron a hot day. If you do cook, usethe grill or the microwave, or elseyoull heat up your kitchen fromusing the oven and stove.

HEAT WAVES

can be DANGEROUS.

Never, EVER leave infants,children or frail elderlyunattended in a parkedcar it can take as little as 10minutes for the temperatureinside a car to rise to levelsthat can kill.

OUTSIDE If you must be out inthe heat, plan ahead.

BEAT THE INDOOR HEAT

Turn off and unplug your appliances. Yourcomputer, your tv, your chargers. All giveoff heat, as does your dishwasher andyour clothes dryer. You'll save energy andkeep the house cooler.

In the hot sun, a wide-brimmed hat,sunglasses, and an umbrella will provideyou with extra shade and protection.

Wear light clothing and sunscreen.Color can make a big difference intemperature and in how you feel. Darkcolors absorb the light and the heat.

Imagine sittingin a living roomwith over110-degreeheat outside.

Spritz and Chill! Fill a spraybottle with water and placeit in the refrigerator until its

cold. When youre about to headoutdoors, grab the bottle, keep itwithin easy reach and mist your-self with a refreshing spritz.

Tip

A very high body temperature candamage the brain and other vitalorgans. Some health conditionscan make it harder for the body tostay cool in hot weather. Theseinclude young children, the elderly,people with chronic diseases,pregnant women, people withdisabilities, people who are sociallyisolated, with obesity, fever,dehydration, heart disease, poorcirculation, sunburn and drug andalcohol use.

Wear loose-fitting clothing tokeep cool and to protect yourskin from the sun and mos-quitoes.

Wear damp terryclothheadbands and wristbands.Place wet towel on the backof your neck and also the topof ones head.

Wear sunglasses that provide100 percent UVA and UVBprotection. Chronic exposureto the sun can causecataracts, which leftuntreated, can lead to blind-ness.

For sun screen it is very wiseto get a good quality one of ahigh SPF. Even if the sun isntbright or it goes behind cloudsfor a while, UV rays can stillaffect your skin.Sunscreenmay also prevent prematureaging.

Sunscreen is OK to use onbabies 6 months or older.The American Academy ofPediatrics and the FDArecommends dressing smallbabies in lightweight cottonclothing, and to protect themby keeping them in the shade.

Use sunscreen even oncloudy days, and apply sun-screen at least 30 minutesbefore going outside.


Excessive heat can be deadly. According to the Centersfor Disease Control (CDC), infants and children up to fouryears of age (as well as people over 65 and the chronicallyill) are at the greatest risk for heat-related illness.

Babies' temperature-regulating systems aren't fully devel-oped; they have fewer sweat glands than adults, so theysweat less. As a result, they're not as efficient as adults inkeeping cool and are very susceptible to hyperthermia --an abnormally high body temperature -- which can be life-threatening.

If a baby's temperature is not brought back to normal,hyperthermia may progress to heat exhaustion, a moreserious condition in which the baby's temperature can climbto 103 degrees, which requires immediate medicalattention. If untreated, heat exhaustion can progress to heatstroke. This is a much more serious condition in which thebody temperature rises above 103 degrees. The result:convulsions, coma and often death. In the U.S., hundredsof babies and young children have died from hyperthermia;tragically, most cases were entirely preventable.

Protect your child from THE HEAT

as much as possible.

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Because many babies can't tell their parents orcaregivers that they're thirsty, they can becomedangerously dehydrated in hot weather, which alsocan lead to hyperthermia. So, it's extremely im-portant to be alert to the following warning signs ofdehydration in babies: Dry mouth or tongue Few tears when crying Few wet diapers (less than six a day) Dark yellow or smelly urine Sunken "soft spots," eyes or cheeks Mottled, grayish, skin that's cool to the touch. High fever Listlessness

The best way to keep babies safe from the heat isto prevent them from becoming overheated anddehydrated in the first place.

Keep your baby indoors in an air-conditioned roomduring heat waves. According to the CDC, thenumber one protection against heat-related illnessand death is air conditioning.

Make sure your baby drinks extra fluids, especiallywater, in warm weather. If you're nursing, youshould increase your fluid intake as well so youdon't become dehydrated.

If you think your babyis dehydrated, TheAmerican Academyof Pediatrics recom-mends that you tryto get him or her todrink an electrolytereplacement solution(such as Pedialyte) orwater, and call yourdoctor immediately.Because dehydrationcauses babies' coretemperature to riserapidly, it puts them atincreased risk forheat exhaustion andheat stroke.


If you're looking for a relaxing place to spendthe day or weekend with family, a warm,sunny beach could be the perfect place. Ourbeaches are a precious natural resource tothose that live and visit San Diego County.

After a trip to the beach, visitors should leavewith sandy feet and smiles, not an illness.

Poor water quality at our beaches not onlythreatens the health of swimmers andbeachgoers but also hurts San Diegos ocean-dependent economy.

The Department of Environmental HealthsBeach and Bay Water Quality Monitoring Pro-gram protects the public health of millions ofresidents and visitors each year through beachwater testing, public education, outreach, andbeach postings. Beach postings can includewater contact advisories and closures whennecessary.

Since 1999 the Department of EnvironmentalHealth (DEH) has contracted with the Califor-nia Department of Public Health, and now theState Water Resources Control Board, to usefunds from the Beach Safety Act (AB 411) toperform water quality sampling, act as a clear-ing house for beach water quality monitoringdata from other agencies and to notify the pub-lic when water quality standards are not metat recreational beaches (ocean and bays).

The Beach and Bay Water Quality MonitoringProgram coordinates the sampling and post-ing of signs warning of contaminated water atbeaches affected by sewage spills. A sign isposted when the bacteria levels exceed Statestandards, or during other events that maypose a threat to the public health and safety.

Since water quality is constantly changingand frequently updated, please visit:sdbeachinfo.com or call the 24-hr. hotlineat: (619) 338-2073 for current water qualityconditions in San Diego County.

Planning a Trip to

the Beach?

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There is no such thing as ahealthy suntan. Every timeyour skin color changesafter sun exposure, its a signof skin damage and your riskof developing sun-relatedillness increases.

Will Sun ProtectionDeprive Me of Vitamin D?

Most people get anadequate amount ofvitamin D from foods andbeverages fortified withvitamin D . If you areconcerned about notgetting enough vitamin D,ask your doctor if you shouldtake a supplement.

Are Tanning Lotions Safe?

This is an importantpublic health issue. Whenthe products do not containa sunscreen, it will notprotect you against sunburnor other harmful effects tothe skin.

The FDA requires that allsuch products carry thefollowing label:Warning:This product doesnot contain a sunscreen anddoes not protect againstsunburn. Repeated expo-sure of unprotected skinwhile tanning may increasethe risk of skin aging, skincancer, and other harmfuleffects to the skin even if youdo not burn.

Is There Such a

Thing as a

Healthy Tan?

How Can I Protect My Kids?

SunWise Program- In response to the serious public health threat raised by overexposureto UV radiation, EPA is A Partnership Program of the U.S. Environmental Protection Agencyworking with schools and communities across the nation. For more information, go to theSunWise Web site: www.epa.gov/sunwise

Babies

Keep babies out of direct sunlight.The American Academy of Pediatricsrecommends using sunscreen on infantsfor small areas such as the face andback of hands where protection fromclothing is inadequate.

Children

Because children will beexposed to UV radiation for theirwhole lives, it is important toengrain sun safety practices atan early age. Many parents donot properly apply sunscreen ontheir children. Sunscreen shouldbe applied and reapplied to allexposed areas. Blisteringsunburns during childhoodsignificantly increases the risk of developing skin cancer later in life.Between 1973 and 2003, cutaneous melanoma increased by 81 percent.Incidence of pediatric melanoma is also on the riseincreasing almost 3percent per yearmaking it just as important to teach children SunWisebehavior. By teaching children about sun safety and encouraging them totake all of SunWises sun safety action steps, parents will ensure that theirchildren understand the dangers associated with sun exposure and the waysto avoid them.

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County efforts have helped keep West Nilevirus at bay in our region, but localresidents need to be reminded of howdangerous the disease can be. And the riskof West Nile virusincreases during thewarmest months of the year, programofficials of Vector Control San DiegoCounty warn.

Last year the highest number of cases anddeaths ever in California was recorded,and in San Diego 11 people werediagnosed with WNV and there were twodeaths.

With educational materials and samples ofmosquito control measures at the FentonPond, in the Otay Valley Regional Park,county officials kicked off the Countys2015 West Nile virus prevention campaign.

"People should protect themselves bystaying inside when mosquitoes are mostactive, at dusk and dawn, and by wearinglong sleeves, pants, and repellent whenoutdoors. By following this advice, San Di-ego County's residents can avoid becom-ing victims of West Nile virus", Supervi-sor Greg Cox said.

"We are working to keep the Aedes aegyptimosquito from becoming established herebecause it can transmit other seriousdiseases like dengue," said Deputy PublicHealth Officer Dr. Eric McDonald, "It is veryimportant to report if mosquitoes are bitingindoors and during daylight hours, so wecan start an immediate investigation".

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Health Officials Warn of

West Nile Virus in San Diego

SD.FightTheBite.com

Photo from news conference fromright to left:San Diego County Supervisor Greg Cox,Dr. Eric McDonald, Medical Director Health and Hu-man Services Epidemiology and Immunization Ser-vices, and Chris Conlan, Supervising Vector Ecolo-gist with the Vector Control Program of SanDiego,kicked off the 2015 West Nile virus seasonby reminding the public to: Prevent, Protect, Report.

"The best way to prevent West Nile virus andother mosquito-borne illnesses is to reducethe number of mosquitoes around your homeand neighborhood and to take personalprecautions to avoid mosquito bites," saidChris Conlan, Supervising Vector Ecologistwith the Vector Control Program of SanDiego. Everyone should remember toeliminate standing water inside and outsidehomes and offices where mosquitoes couldbreed. Pay special attention to plant saucers,flower vases and unused tires. Avoiding anyobjects that may contain water will help stopall kinds of mosquitoes from breeding," Conlansaid.

For updates follow us in: Twitter@SDFighttheBite

County officials said the public can keep up with West Nile virus activity and anonymouslyreport dead birds and green swimming pools. To make a report and more information pleasecall (858) 694-2888 or visit:


HEATStages of

When temperatures are on therise, watch for the followingSigns & Symptoms of Heat-Re-lated Illness.

Drink water. The first stage isthirst. By the time your body tellsyou are thirsty, you are alreadymildly dehydrated. Drinkingwater at this stage can preventyou from progressing tothe more serious kinds of heat-related illnesses.

Not drinking enough waterduring hot weather or exercisemay cause dehydration. Getimmediate medical care if youdevelop symptoms such asextreme thirst, a lack ofurination, shriveled skin,dizziness and confusion.

Anyone may becomedehydrated, but young children,older adults and people withchronic illnesses are most atrisk. The safest approach isprevention of dehydration.Monitor your fluid loss duringhot weather, illness or exercise,and drink enough liquids toreplace what you lose.You should carry water with youand drink even if you dont feelthirsty.

Avoid alcohol and caffeine, whichdehydrate the body, and avoidusing salt tablets unless directedto do so by a physician.

The loss of water and salt fromheavy sweating causes heatcramps.

Heat cramps are muscular painsand spasms due to heavyexertion, and usually involve theabdominal muscles or the legs.

These cramps can be mild or verypainful. If you are caring for aperson who has heat cramps,have him or her stop activity andrest. If the person is fully awakeand alert, have him or her drinksmall amounts of cool water orsports drink. Gently stretch thecramped muscle and hold thestretch for about 20 seconds,then gently massage the muscle.Repeat these steps if necessary.If the victim has no other signalsof heat-related illness, the personmay resume activity after thecramps stop.

heat exhaustion, sweat doesnot evaporate as it should,possibly because of high hu-midity or too many layers ofclothing. As a result, thebody is not cooled properly.

Signs include cool, moist,pale, flushed or red skin;(the skin may be red rightafter physical activity),heavy sweating; headache;nausea or vomiting;dizziness and weakness orexhaustion. Body tempera-ture will be near normal.Theskin may or may not feel hot.

Related illness

THIRST1

HEAT

CRAMPS2

HEAT

EXHAUSTION3Heat exhaustion occurs whenpeople exercise heavily or workin a warm, humid place wherebody fluids are lost throughheavy sweating.

Fluid loss causes blood flow todecrease in the vital organs,resulting in a form of shock. With

Also known as sunstroke,heat stroke is life-threaten-ing. The victim's temperaturecontrol system, whichproduces sweating to coolthe body, stops working. Thebody temperature can riseso high that brain damageand death may result if thebody is not cooled quickly.

Heat stroke is lifethreatening.Call 9-1-1

The warning signs of heatstroke or sun stroke vary butmay include: hot, red, and dry skin changes in consciousness rapid weak pulse rapid, shallow breathing body temperature can bevery highsometimes ashigh as 105 F.

HEAT

STROKE4

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HEATFirst Aid for

Related illness

General care for heatemergencies includecooling the body, givingfluids, and minimizingshock. For specificheat-related emergencies,follow these steps:

Take anti-inflammatorymedications recommendedby your health care provideror your local pharmacist.These will help to stopinflammation and reduce theamount of redness and pain.It is important to take themearly as they can help blockthe release of interleukins,the skins main sunburncytokine.

Apply cool compresses andcool moisturizers. TryEucerin Calming Cream,Aloe Vera Gel or Aveno ColdCream. Apply generously.You can put it in therefrigerator for a few hoursbefore applying to your burn.

Avoid hot showers. Instead,take a luke warm bath withAveeno Collodial Oatmeal.The oatmeal is both asoothing anti-inflammatoryand a moisturizer, which arethe two things your skinneeds most.

SUNBURN

Avoid any additional sunexposure. The best way is tocover up with clothing; apply-ing a sunscreen to a sunburncan worsen the inflammationand itching.

If you have blisters, resist theurge to pop them. They forma protectant seal on your skin;if they tear, the sensitiveunderlayers of skin will beexposed. You wont like it.Dont peel off the dead skineither; rather let it slough offon its own in the shower. Ifyou have extensive burns orblistering, see your physician.He or she can prescribetopical steroids to helpminimize the inflammation.

Avoid numbing sprays suchas benzocaine. Although theycan feel great when applied,they are notorious forcausing allergic contactdermatitis. If you think asunburn is bad, try adding anincredibly itchy, allergiccontact dermatitis on top of asunburn. As one of mypatients put it: Its like beingtied down on a hill of fire ants.

them, as they can makeconditions worse. Loosen tightclothing and apply cool, wetcloths such as towels or wetsheets or mist with water.Get the person into an airconditioned space if possible.Call 9-1-1 or the localemergency number if theperson refuses water, vomitsor loses consciousness.

HEAT EXHAUSTION

Get the person to a coolerplace and have the personrest in a comfortable position.If the person is fully awakeand alert, give a half glass ofcool water every 15 minutes.Do not let him or her drink tooquickly. Do not give liquidswith alcohol or caffeine in

HEAT STROKE

Heat stroke is alife-threateningsituation! Call 9-1-1.

Move the person to a coolerplace.

Quickly cool the body usingany means available, inclu-ding cool water and ice.

If you have ice packs or coldpacks, wrap them in a clothand place them on each of thevictim's wrists and ankles, inthe armpits and on the neckto cool the large blood ves-sels.

Do not use rubbing alcohol be-cause it closes the skin'spores and prevents heat loss.

Wrap wet sheets around thebody and place the person infront of a fan or air conditioner.

Watch for signals of breathingproblems and make sure theairway is clear. Keep theperson lying down.

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Our bodies need water

to work properly

WATER IS LIFE!

The human body is about 60% water. Most of themajor functions in the body depend on water. Watercarries nutrients and oxygen to cells and aidsnutrient absorption in the body.

Dehydration occurs when the body has insufficientwater to function properly. Several studies have shownthat even mild dehydration can have adverse effects.With the time, dehydration can lead to blood clots,seizures, and other potentially fatal complications.According to the National Institutes of Health, cartilage,the slippery coating at the end of each bone, iscomprised of 65 to 80 percent water. Synovial fluidkeeps cartilage healthy, slick and smooth, properlycushioning joints if properly hydrated.

Lose even 1.5% of that and it can affect the mood,energy evels, and cognitive function all drop, accord-ing to research from the University of Connecticut.

One study, conducted by Tufts University researcherson college athletes, concluded that subjects whoengaged in high-intensity aerobic exercise for at leastan hour and did not properly hydrate, were more proneto feeling angry and depressed. The studys lesson:our mood is sensitive to fluid balance.

Pregnancy and breastfed babies increase water needs.Dehydration may have an effect in the composition ofthe milk and decreasing the amount of milk produced.Dehydration will also add to feelings of tiredness at whatcan be a very stressful time.

Moreover, a dehydrated brain also has to use a lot moreenergy to accomplish the same tasks, shows a studyfrom Kings College London. After comparing the headsof slightly dehydrated teens to those of their properlywatered peers.The study team concluded that, as a re-sult of their dehydration, the teens brains had to workharder to function normally. Since brainpower is a lim-ited resource, your mind sans water is like a cell phonewithout a proper charge.

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Increased thirst Dry mouth andswollen tongue Weakness Dizziness Palpitations Confusion

Signs and indicators

When it is an emergency

When seek

medical care

Vomiting for more than a day Fever over 101F Diarrhea for more than 2 days Weight loss Confusion Weakness

Take the person to theemergency department ifthese situations occur:

Confusion Headache Seizures Fainting Difficulty breathing Fever higher than 103F Sluggishness (lethargy) Chest or abdominal pains No urine- the last 12 hours

The signs and symptoms canrange from minor to severe andinclude:

Sluggish-ness fainting Fainting Inability tosweat Decreasedurine

Urine color may indicate dehydra-tion. If urine is concentrated yellowor amber, you may be dehydrated.

Theres even evidence that your brainwill shrink if youre dehydrated, showsa study from Harvard Medical School.Like plant leaves without water, the cellsin your brain appear to dry out and con-tract when deprived of fluid, the Harvardresearch indicates. On the other hand,studies show this kind of rapid over-hy-dration of the brain can lead to cell dam-age or rupturesnot common for mostpeople but a slight risk for enduranceathletes who may become massivelydehydrated before taking in big amountsof fluid. Drink small amounts of waterthroughout the day to avoid all this.

The amount of water we need to drinkeach day can vary. Some factors canincrease the need for fluid, such as: Hot and humid weather, Increased physical activity, Dry indoor air and high altitudes, Being pregnant or breasfeeding Having diabetes or an illness accom-panied by fever, vomiting or diarrhea

As the level of water loss and need in-creases, more symptoms can becomeapparent. Severe dehydration is a medi-cal emergency.

For healthy adults thirst means that theyalready waited too long, but thirst isn'talways a reliable warning of the body'sneed for water, especially in children andolder adults. As adults get older, theymay experience less thirst, so its ad-vised to drink before thirst sets in. TheUniversity of Maryland Medical Centerrecommends drinking 6-8 glasses of wa-ter per day to possibly stave off osteoar-thritis, the most common form of the jointdisease known as arthritis.

If you become mildly to moderately de-hydrated while working outside or exer-cising. Stop. Look for a cool spot, suchas in the shade or an air-conditionedarea. Drink cool water. Fruit juices orsodas are not recommended, becauseit is not absorbed as rapidly as it is need.

DEHYDRATION

13

COUNTY OF SAN DIEGO

The Department of Housingand Community Development

Protect

Your Family

From Lead

In Your

Home

Lead from paint chips, whichyou can see, and lead dust, whichyou cant always see, can both beserious hazards.

Removing lead improperlycan increase the hazard to yourfamily by spreading even morelead dust around the house.

Just knowing that a home haslead-based paint may not tell youif there is a hazard.

The National LeadInformation Center1- 800-424-LEAD


When the temperature rises, nothing beats a sweet, juicypiece of fruit or the crisp crunch of a fresh veggie. Whata wonderful way to quench thirst; consume vitamins,fiber, antioxidants and good food!

According to a recent Harvard study, more than half ofAmerican children are dehydrated, which can haverepercussions for their physical health and academicperformance.

What you give your child will significantly impact theirdaily calories and overall weight, says Cleveland Clinicregistered dietitian Sara Seither, MS, RD, CSP, LD. "Plainwater is the best way to go. It provides hydration andquenches thirst without adding any calories, fat or sugar,Ms. Seither says.

If you drink only soda as your beverage of choice,you may be at risk for weight gain. Consumingan extra 3,500 calories leads to 1 pound of weightgain, explains the U.S. Department of Health andHuman Services. For example, if you drink five100-calorie sodas per day totalling 500 calories,you can gain 1 pound in a week. Start by exchang-ing one soda per day for a glass of water. Thiscuts out around 700 calories from your diet perweek, which may help with weight loss if you con-tinue to eliminate soda drinks.

Here are a few tricks to try: Freeze 100% juicein ice cube trays. Add it to plain water for a kickof fruit juice flavor for less sugar and calories thana full glass of juice.

Lets Make a Good Choice!

What you drink can make a BIG difference!

You can add a shot of flavor, without

piling on the sugar, calories, or

chemicals.

Put cut up fruit in a large pitcher of water in therefrigerator it only takes a small amount offruit (think one sliced lemon or lime) to flavor alarge container of water.

A 20-ounce bottle of regular soda, sports drink or fruitjuice contained 250 calories and 16 tablespoons of sugar,which would require 50 minutes of running or 5 miles ofwalking to burn off,according to one study publishedonline in the American Journal of Public Health.

Just let fruit and herbs sit in water

for an hour and enjoy!



Add frozen fruit. Slip somefrozen fruit, such as berries ormango chunks, into your waterbottle. As the fruit thaws, it coolsyour drink and releasessweetness and fruit flavor. Andif you gobble up the fruit afteryoure finished sipping, you geta dose of antioxidants to boot.

Chop some fresh mint leaves (oranother preferred herb), sprinklethe herbs into each cell of an icecube tray, cover with water, andfreeze into cubes. Add a few mintcubes to your water bottle, alongwith fruit or cucumber slices ifdesired, for a refreshing, sophis-ticated drink.

Add a splash of fruit juice.Adding just a splash of 100% fruitjuice, such as cranberry or grape,to your water bottle gives you ahit of all-natural sweetness andflavor for a fraction of the calo-ries and sugar you would getfrom a full glass of juice.

Get zesty with citrus. Lemonwedges, few slices ofgrapefruit, orange, or lime (or amixture of different citrus) canadd new life to your water.Grapefruit and mint is a greatcombo!

To enjoy the long days the mostwe need more energy. Studiesshow that eating a healthybreakfast can help withcognitive function (especiallymemory) and even improvemood.

Smoothies are so easy to makeand are ready in seconds.Smoothies taste delicious andprovide important protein,vitamins and minerals.Convenient and portable,smoothies are ideal fuel-on-the-go for breakfast.

To get the most flavor and nu-trients into your smoothies, donttake up space with ice. Instead,use frozen fruit or portion outyour own fruit (berries or ba-nanas are good choices) andkeep them sliced in the freezerfor instant access. You can alsoadd an extra kick with powderproteins and vitamin mixes.

Quench Your Thirst

With Fresh Foods!

15

Search for ingredient and experiment with your favorite flavor combinations!

Mixed fruit and vegetable smoothiesare the perfect plan for getting kids toeat vegetables.

With hundreds of thousands ofcombinations of fruits and veggies,smoothies make it easy to get thenutritional benefits of breakfastwithout getting boring.

Make purely fruit smoothies a fewtimes so the kids grow to LOVE them.Then, start experimenting with add-ing a vegetable here and there.

Spinach is the most common greenused in green smoothies because ithas a mild flavor, a soft texture and iseasy to blend. The flavor of spinachis easy to mask with fruit.

Carrots or baby carrots grind up topure liquid and the taste goes wellwith apples and many other fruits.

Avocados can make a great base fora high-energy green smoothie thatwill satisfy you and keep you goingfor hours.


1-888-WIC-SYHC

Pregnant, breastfeeding, or have children under 5 years old

You can get:

Breastfeeding support

Nutrition and health education

Referrals to health care

WIC checks for healthy foods

Low wage, working families (and migrants)

are welcome to apply

If you are:

( 1-888-942-7942)

This institution is an equal opportunity provider.

16


1- Plan ahead! Before you head to the grocerystore, plan your meals for the week. Check tosee what foods you already have and make alist for what you need to buy.

2-Check sales and coupons. Ask for extrasavings at stores where you shop. Look forspecials or sales on meat and seafoodoftenthe most expensive items on your list.

3- Compare. Locate the Unit Price, differentbrands, weight and sizes of the same productto determine which is more economical.

4- Carefully read food labels whilein the storeto make sure food is not close or past its sellby date.

5 -Buying fruits and vegetables in season canlower the cost and add to the freshness! If youare not going to use them all right away, buysome that still need time to ripen.

6- Buy in bulk. Smart choices are family packsof chicken, steak, or fish and larger bags of po-tatoes and frozen vegetables. Before you shop,remember to check if you have enough freezerspace.

7-Certain foods are typically low-cost optionsall year round. Try beans for a less expensiveprotein food. For vegetables, buy carrots,greens, or potatoes. As for fruits, apples andbananas are good choices.

8- Put raw packaged meat,poultry, or seafoodinto a plastic bag before placing it in the shop-ping cart, so that its juices will not drip onandcontaminateother foods.

9 - Prepare a large batch of favorite recipes on your dayoff (double or triple the recipe). Freeze in individual con-tainers. Use them throughout the week and you wont haveto spend money and time on take-out or dinner meals.

10 - Spice up your leftoversuse them in new ways. Forexample, try leftover chicken in a stir-fry or over a gardensalad, or to make chicken chili. Remember, throwing awayfood is throwing away your money!

Fruit and vegetables are usuallycheaper if they're in season!

10 Tips to help you

stretch your food dollars

17


How long can you

Internet brain games arent the only way to gaugewhats going on inside our head. A simple physicaltest may be able to tell us how healthy our brain is,according to a new study published in the journalStroke.

Stand on One Foot?

Our study found that the ability to balance onone leg is an important test for brain health, saidYasuharu Tabara, Ph.D., lead study author andassociate professor at the Center for GenomicMedicine at Kyoto University, Japan.

as possible, up to a minute. Then they performedMRIs on the subjects, whose average age was67, and had them complete four cognitive tests.Interestingly, the length of time the people couldbalance predicted what the scientists saw on thebrain scans. Those who had trouble standing onone leg for 20 seconds or longer were more likelyto have cerebral small vessel disease, a condi-tion where tiny blood vessels deep in the brainare damaged and deprives local areas of thebrain of sufficient blood supply to carry out nor-mal activities. None of the study participantsshowed any symptoms.

In the study, re-searchers had 1,387healthy people standon one leg with theireyes open for as long

One-leg standing time is a simple measure of posturalinstability and might be a consequence of the presenceof brain abnormalities, added Tabara.

Specifically, 16 percent of folks who struggled to bal-ance, have a small, damaged area of the brain where ablood vessel has clogged. About a third of those withmore than two of these lesions had trouble standing onone foot. Likewise, 15 percent of people with onemicrobleed brain lesion a minor hemorrhage due to adamaged vessel and 30 percent with more than twosuch lesions had poor balance.

18

These trouble spots in the brain are what RichardSenelick, M.D., a neurologist and medical directorof the HealthSouth Rehabilitation Institute of SanAntonio, calls silent strokes. You have tiny littleblood vessels throughout your brain theyre mi-croscopic, he says. They can close off, and youget little damaged areas of the brain, but no symp-toms. Theyre more common in people who areolder or who have hypertension (particularly if itsuncontrolled) or diabetes.

If you get enough of these, you can ac-tually get a type of dementia, called avascular dementia, Senelick says.

In the study, short standingtimes were independently as-sociated with poorer perfor-mance on the cognitive tests.

So why the difficulty balancing? This studysuggests that one component of gait bal-ance may be especially tied to brain health,possibly because it reflects early brainchanges that dont necessarily cause symp-toms, but increase risk of stroke.

Yet, Senelick cautions against auto-matically concluding you face an el-evated risk of stroke if your balanceis poor. As you age, your vision canbecome cloudy, your hearing may de-

cline, your joints stiffen, and the sense of whereyour body is in space worsens. All factors that mayaffect your ability to stand on one leg for a long time.In fact, in the study, the older participants were, themore trouble they had for balancing.

Despite the results are, it does suggest you mayneed to seek a professional evaluation.Individualsshowing poor balance on one leg should receiveincreased attention, as this may indicate increasedrisk for brain disease and cognitive decline.Senelick says. People should remember that If itsgood for your heart, its good for your brain. Peopleshould work on their risk factors: hypertension, dia-betes, poor diet, lack of exercise, smoking. advicedSenelick.


Physical health benefits from regularexercise are well known lowerblood pressure, better management,prevention of diabetes, lower bloodcholesterol, and more. While thesehealth improvements develop over aperiod of time, there is one immedi-ate benefit to physical activity. Whichtranslates to: helps manage weight,improves muscle and bone strength,and even lifts your spirits. It can alsoadd years to your life!

Feeling better to enjoy the life withyour loved ones is the most powerfulreason to move your body more.When you feel better, you have a bet-ter outlook on life, you are better ableto handle stress that comes your way,you feel more energetic, and you restbetter at night.

People have been looking for thesecret to a long and healthy life formillennia, says Neil Resnick, MD,chief of the division of geriatrics andassociate director of the University ofPittsburgh Institute on Aging. It turnsout the most powerful intervention isexercise.

The Anti-Aging

Powers of Exercise

Physical activity is one of the best ways to energize your body after along day at work. Walking may not be what you feel like doing when youget home, but it could be exactly what you need. Exercising regularlyclears your mind and you can actually accomplish more.

According to National Institute on Aging, in some cases, exercise is aneffective treatment for many chronic conditions. For example, studiesshow that people with arthritis, heart disease, or diabetes benefitfrom regular exercise. It also helps people with high blood pressure,balancing problems, or difficulty walking. You will note changes in yourmood,you will sleep better, you will feel more energetic, and of any otherimprovements in how you feel.

You can reap the benefits from regular physical activityat any age. Feeling better is your greatest reward.

According to the Go4Life campaign safety advice, people should takesome precautions to exercise safely and talk with their doctor.

Stop exercising if you: have pain or pressure in your chest, neck, shoul-der, or arm; feel dizzy or sick to your stomach; break out in a cold sweat;have muscle cramps; feel severe pain in joints; preventing injury feet,ankles, or legs.

When exercising outdoors, pay attention to your surroundings consider possible traffic hazards, the weather, uneven walking surfaces,and strangers.

Why do you feel better afterexercise?

Physical activity deliversoxygen and nutrients to yourtissues, and your heart andlungs work more efficiently.That is why you feel morealert and have more energyto do things you enjoy.

19

" If you really want to know your community, you better go by bike"said San Diego County Supervisor Greg Cox while enjoying of ridinghis bike on the Bayshore Bikeway.


Focus on posture: Sit on your sitz bones.Tighten your belly, lift the rib cage, hold yourneck long and straight, and tuck your chindown and back so you feel a long stretch onthe back of your neck. This alone can be atough position but youll need it for everyother move you do.

While youre holding an upright posture,march in place with your seat firmly planted.Swing the opposite arm as you march eachfoot forward.Try alternating marches with toetaps and heel taps. Use either the same oropposite arm or both arms at once. You cando a little boxing maneuver with jabs, upper-cuts, a cross punch, and a hook. If youre newto exercise, marching in place with arm move-ments for 20 minutes will get your heart ratepumping to aerobic levels.

Form a goalpost with your arms: Keep your upper arms(shoulders to elbows) parallel to the floor and your lowerarms (elbows to hands) perpendicular to it. Bring your fore-arms together in front of your face. Return your arms to thestarting point, squeezing your shoulder blades together, andrepeat as long as you can hold proper form. Your back, chest,and arms will get a workout.

The benefits of exercise are not restricted topeople who have full mobility. Cardiovascu-lar and flexibility chair exercises are a seriesof seated repetitive movements, that willraise your heart rate and help you burncalories. It can help to improve posture, re-duce back pain, and to alleviate body sorescaused by sitting in the same position for longperiods. Theyre also a great way tosqueeze-in a workout at work or while yourewatching TV.

Cardio Workout

in Your Chair!

GET READY!

1. MARCH IN PLACE!

3. JUMPING JACK!

2. DO THE PEEKABOO!

4. RELEASE SOME TENSION!

5. MOVE YOUR JOINTS

Start with knees bent and arms resting at your sides; thenextend your legs, straight and wide, with heels on the floor,and raise your arms in a V. Then bring your limbs back to thecenter. Repeat for several minutes. It does actually elevatethe heart rate and give you an aerobic benefit, but the key isto do it long enoughat least 10 minutes or so.

With the best posture you can muster, stretch and reach yourarms overhead so that youre lengthening your spine. Alter-nate moving your hands as though youre climbing a rope,pulling yourself up. This is a great exercise to get people tonot squish their spines.

We need to lubricate the joints, which means moving thosejoints in a gentle way to get synovial fluid (the liquid thatprotects joints) moving. When you flex it, you wring it out,and when you relax it, liquid is let back in. Shoulder rolls aregreat for this because they make four major muscle groupsmeet. Bring your shoulders forward, up to your ears, back,and then relax. Repeat as long as it feels good. Before youswitch to roll your shoulders backwards, let your arms hangand swing gently, like pendulums.

1. 2. 3. 4.

20 Salud+HEALTHinfo.com ISSUE # 48 VOL. 13 2015


The next level is more severe and may require:

sweating and shaky, dizzy and confused, pale and slurring words acting strangely, angry or explosive... Sudden hunger Headache Shaking Weakness Poor coordination Difficulty in concentrating Staggering Fast or pounding heartbeat Fatigue or with feelings of restlessness Nightmares with night sweats

Recognizing the symptoms

EARLY STAGES

EMERGENCY TREATMENT

Blurred or double vision Confusion Nervousness and agitation Drowsiness Numbness or tingling around mouth and lips Loss of consciousness (passing out or fainting)

After something happen...they feel re-energized. It'slike theyre a completely different person.Theirpersonality changes, they are happy, and theyhave energy to go tackle the day. Also, you'll noticethat often times they will forget that they were over-reacting, or that they just hurt your feelings earlier.

Spotting the symptoms is extremely difficult whenyou dont know what to look for. In the early stages,the person may be:

Do you know somebody whos irritable, depressed,or anxious in the morning, and then somethinghappens, and all of sudden everything changes?

HEATSTROKE?

ALCOHOL?

DRUGS?

6. FOCUS ON

EXTREMITIES

Start working the wristsfirst. Hold your armsstraight in front of you andflex the wrist. Then rotateyour palm so your finger-tips point toward the floor.Repeat until you feel thestretch. When working theankles, draw letters of thealphabet with each foot.

You can add resistancebands or light [ankle]weights, to gain strength.Now you can work yourentire upper bodyhold-ing the ends of the bandin your hands, try startingwith bicep curls.

If you put all these movestogether, you can work upto your 30 minutes of ex-ercise per day. You candivide the time in 10-minute chunks if yourejust starting off. Start slowand listen to your body.You should not have anypain when youre exercis-ing. If you go to a point ofmild discomfort, then backoff. Talk to your doctor be-fore making any bigchange in your exerciseplan.

The information in this article,including the illustrations by DavidPreiss, was excerpted from ahandout made by DiabetesForecast. The information wasedited to be published with largertext for community education andhealth promotion. With no commer-cial interests. People should consulta healthcare professional beforestarting any diet, exercise, orsupplementation program.

DEPRESSION? or INSULIN SHOCK? The answer is on page 31


Advance Care PlaningMaking Your Wishes Known

Are you a Grandparent

Raising Grandchildren?

At Sharp HealthCare, we have been caring forSan Diegans for more than 50 years. And whileno one likes to think about what if when it comesto personal health, drafting a plan for your healthcare wishes today can be an important tool foryou and your loved ones down the road.

Advance care planning empowers you to makehealth care decisions ahead of time and com-municate your wishes to family members orfriends. Having a plan in place helps ensure youllget the care you want even if a loved one has tomake health care decisions on your behalf.

A Free ServiceSharp Advance Care Planning is a free, confi-dential service available to help adults of any ageor health status explore and document beliefs,values and goals as they relate to health care.You do not have to be a Sharp patient to partici-pate.

Our advance care planning facilitators aretrained, discreet and compassionate individualswho are available by phone, email or in-personappointment to discuss personal preferencesabout health care decisions. A facilitator can helpyou learn how to create a dialogue with yourfriends or family members, and can assist you inpreparing an advance directive to serve as legaldocumentation of your health care wishes.

Getting StartedDownload an advance care directive form atwww.sharp.com/advancedirective or call (619)517-9798 to schedule a personal consultationwith an advance care planning facilitator.

SHARP

22

Supervisor Greg Cox has spearheaded the effort toprovide more assistance to grandparents and otherrelatives who are raising grandchildren. Many of theseyoungsters would have been placed in foster care if theirgrandparents hadnt stepped forward to take care ofthem.

Grandparents Raising Grandchildren coalitions haveformed and there are now regular regional events toeducate these family members and provide respite forthem. The YMCA has been a big partner in this effort asthey administer the Kinship Support Program.

One of the major educational tools created by the YMCAand sponsored by Supervisor Cox is the Handbook forGrandparents and Other Relatives RaisingChildren. A recently revised handbook is nowavailable and contains such topics as legal rights,permanency options, safety issues, public benefi ts,health care options, support groups and other resources.

The updated handbook is available online. To accessthis information, go to www.211SanDiego.organd look under Resources & Services, then clickGrandparents Raising Grandchildren.

To request a printed copy of the handbook, emailMelissa Brooks at [email protected] or call her at(619) 543-9850, ext. 12440.


Veterans Benefit from New Partnership

By Ellen Schmeding, Director, County Aging & Independence Services

Without help, 90-year-old ThomasRuiz would probably be in a nursinghome. The World War II Navy vet-eran has lungs severely damagedfrom exposure to asbestos and aheart that needs a new valve, buthes not a candidate for surgery.Hes tethered to oxygen that runsconstantly, yet he still gets windedwalking from one end of his mobilehome to the other.

His wife of 65 years, Anita, dotes onhim as much as she can but her os-teoporosis creates physical limita-tions.

The Veterans Affairs San DiegoHealthCare System (VASDHS)could have steered Toms care to afacility, but instead is working withAIS on a new program that helpsveterans in his situation remainhome.

The program - San Diego VeteransIndependence Services at Any Age(SD-VISA) - is the first of its kind inCalifornia. Instead of costly nursinghome care, the veterans selected forthis partnership are provided a bud-get and meet with an Aging & Inde-pendence Services social workerDonna Brown, who has the title ofVISA Options Counselor. Together,they work on a spending plan that isbased on the unique needs of eachveteran. The veteran is then referredto Premier Healthcare Services(PHS), which acts as the payrollagent, managing timesheets, pay-roll, taxes and even backgroundclearances.

23

The most important aspect is that thecare decisions are veteran-directed,selected by the veteran or thatveterans representative, Donnasays. Most of the monthly paymentusually goes to hiring a caregiver.Other uses have included buying aspecial chair or bed, even alarms if theveteran has dementia and can wan-der.

The SD-VISA partnership is a yearold. The federal Veterans Health Ad-ministration allotted slots for 30 veter-ans for the first year in San DiegoCounty. The VASDHS must refer aveteran to the program rather thanself-referrals. This ensures the partici-pants are those most in need for thisassistance. Besides providing patient-centered care, it is hoped that the pro-gram will also save health care costs.

As with most families,Toms greatest need hasbeen for someone totackle what he and Anitacant: grocery shopping,cooking, cleaning, laun-dry, transportation, etc.The SD-VISA budget al-lowed him to hire thishelp, so he picked one ofhis six sons, Ben, whomoved into their mobilehome last year.

Ben was in a better posi-tion than his other broth-ers to move out of his ownhome and become thelive-in caregiver, plus herealized he was putting150 miles on his truckeach day helping out hisfolks anyway.

He says the program willbe particularly helpfulsoon when he needs togo out of town to visit oneof his own sons. Tom willhave the funds to hiresomeone else to coverthe two weeks that Ben isaway.

Tom Ruiz with Anita and Ben

Continued on page 29


Regional Plan to Tackle

Alzheimer's Disease

Gets Go Ahead

Alzheimers disease is much more thanmemory loss and impaired thinking skills; itis a progressive, fatal disease for which thereis no cure and only minimal treatment op-tions. And, it is on the rise.

More than 60,000 San Diegans are livingwith Alzheimers a number that is expectedto climb to 100,000 by 2030.

The Alzheimers Project: A Call to Armsgrows out of the dedicated efforts of SanDiegos world-class researchers,Alzheimers care providers, County and Cityelected leaders, caregivers, healthcare pro-viders, public safety personnel and manyothers who contributed their time, expertiseand experience to put the region on trackfor tackling the challenges posed by thisdebilitating and heart-breaking disease.

There is no cure for the disease, but a broad-reaching effort launched by the San DiegoCounty Board of Supervisors is aimed atmaking the county the epicenter of progressin discovering a cure and improving the livesof the 60,000 county residents that currentlysuffer from the disease.

We are here today for all those with thisdisease and all those that care for them,Jacob said. No one should have to face thisdisease alone.

The project, part of the Countys Live WellSan Diego, has already made progresson several fronts with new resources andimprovements to existing ones.

The UC San Diego Shiley-Marcos Alzheimers DiseaseResearch Center (ADRC) is looking for elderly Hispan-ics, over the age of 65, who are interested in researchon aging, the brain and Alzheimers disease.

Aging Latinos may have different factors that protect themor put them at risk for Alzheimers disease. This mayinclude differences such as genetics, diabetes, bilingual-ism, and other factors that may influence brain health.Participation is very important to help us to learn aboutmeasuring risk and advising people about promotinghealthy brain aging and preventing Alzheimers disease.

We are looking for persons with a diagnosis ofAlzheimers disease, those with Mild Cognitive Impair-ment (MCI) who have some problems with their thinkingskills but not sufficient to be classified as having demen-tia, and persons with normal cognition who can take partin studies related to healthy brain aging.

DO YOU OR SOMEONE YOU

KNOW HAVE CONCERNS

ABOUT MEMORY?

Much of the research as-sessment can be done inthe South Bay and we willbe able to do some as-sessments through homevisits. For some partici-pants, additional assess-ments may be done in LaJolla, near the UCSDcampus. You can be in-volved at multiple levelsin research. Some stud-ies are only one visit, oth-ers are longitudinal withannual follow-ups.

We also are offering clinical trials with experimental medi-cations. To learn more about research opportunities atthe Shiley Marcos ADRC, please contact by emailFrances Martinez-Goodrich or by calling to 858-822-4800. We have bilingual bicultural staff.

24


Senior citizens are some of themost vulnerable members ofour society, which is why theDAs Office has a special unitdedicated to protect them fromelder abuse and investigatinglong-term care homes. The unitwas created one year ago witha mission to better-protect se-niors and to raise public aware-ness about preventing and re-porting abuse and neglect ofsome of our most vulnerablecitizens.

Felony charges have been filed in five of those cases. Fifty-six of the cases arestill under review and 50 have been rejected because of lack of sufficient evi-dence.

We trust facilities to care for our elderly loved ones in their twilight years andthis unit is helping to ensure that individuals are held accountable when theirfailure to live up to that responsibility becomes criminal, DA Dumanis said.Were working to help even more victims of elder abuse and to stop those whoprey on them.

This unit would not have been possible without the support of SupervisorsJacob and Cox, who both worked diligently to bring attention to potential abuseat assisted living facilities, DA Dumanis said. The experienced prosecutors,investigators and support staff in the DAs Family Protection Division have donethe heavy lifting to make connections with state agencies and law enforcementand hold these facilities accountable.

The special prosecutorialunit has become a potentweapon in our efforts tocrack down on abuse andneglect, but the county ismoving to do even more,said Supervisor DianneJacob. We beefed up apatient advocacy programlast year and we're pre-paring to launch a ratingsystem to highlight theregion's better facilities.Supervisor Greg Cox ech-oed that sentiment.

We promised we wouldgo after anyone whoharms our seniors andthese results show wemean business, saidCounty Supervisor GregCox. Were going to con-tinue targeting peoplewho commit elder abuseand we encourage thepublic to let us know if theysee anything that we needto investigate.

The advancements thespecial prosecutions unithas made in developingrelationships with Com-munity Care Licensing,which is part of the De-partment of Public Health,with the AttorneyGenerals Office and withother consumer advo-cates, has been critical toits success.

For example, a new pro-tocol has been estab-lished a first of its kindin San Diego County inwhich Community Care

The Long Term CareSpecial ProsecutionsUnit, which has two anda half dedicated prosecu-tors, three investigatorsand two paralegals.Since its launch, hasopened 113 cases.

Are you worried about ... Your loved ones

living in an assisted living facility?

25


Licensing sends reports of possibleabuse via email to the District Attorneyand Attorney Generals Office eachmonth. The responsibility for respond-ing to the reports alternates each monthbetween the District Attorney and the At-torney General. Once a report is re-ceived, it is pre-screened for whether theincident merits further investigation andeventually charges.

Deputy District Attorney Paul Green-wood, a national leader in elder abuseprosecution, oversees the unit. He hasconducted trainings with various com-munity groups on how to identify redflags and other indicators of neglect,physical abuse, financial exploitation,emotional abuse, abandonment andfalse imprisonment all components ofthe Elder Abuse Statute under PenalCode section 368.

An emerging problem across SanDiego County is an increase in thenumber of unlicensed facilities. Lawenforcement agencies spend hoursresponding to psychiatric calls at suchestablishments. The District AttorneysOffice is working to identify thesefacilities and forming criteria that wouldenable us to assist with getting thebusiness licensed or shut down. It iscurrently a mis demeanor to operate aresidential care facility without a statelicense.

The public can learn more about the unitthat holds suspects accountable througha new website and can report suspectedabuse on a new reporting line.

The public may view the web page at: www.sdcda.org. The phone number toreport abuse is: 619-531-3342. Calls willbe screened by DA staff for potentialfollow-up by Deputy DAs and investiga-tors.

Photo from news conference from left to right: Supervisor Greg Cox, DA Bonnie Dumanis,Supervisor Dianne Jacob, and Mark Sellers of Aging & Independence Services (HHSA).

This is a great example of our regional and state leadersworking together to improve the health and safety of older adultsreceiving care in facilities in our community, said Nick Macchione,Director of the County Health and Human Services Agency. Theseare innovative solutions that are showing real results.

Mandatory reporters are any person who has assumedfull or partial responsibility for the needs or care of an elderor dependent adult. Other mandatory reporters includehealth practitioners, law enforcement and emergency re-sponse personnel, the clergy, public social service employ-ees or any other elder or dependent adult care custodian.

Anyone can make a referral to Adult Protective Services (APS),not just mandated reporters. To make a report of elder or depen-dent adult abuse, call 800-510-2020 (within San Diego County)or 800-339-4661 (outside the County). Mandated reporters canuse an online system to make a referral.To use the online sys-tem please visit: AISWebReferral.org

What must be reported? Call 911 if a life-threateningsituation is in progress Contact APS for any observation or sus-picion of physical abuse, financial abuse, abandonment, isola-tion, abduction, neglect by others or neglect by self.

Who is a Mandatory Reporter?

26


By the time wefound out the truth,all her money wasgone.

Pay attention if yourelderly parentsroutine changes allof a sudden.

I wish I had.

Do not isolate yourself -stay involved. Always tell solicitors:"I never buy from or give to anyone who calls or visits me unannounced. Send me something in writting." Change your online password quarterly. Shred all receipts that contain your credit card number. Sign up for the "Do Not Call" list at: 1-888-382-1222 and the "Opt Out Mailing" list at: 1-888-567-8688. Always have a second line of defense at your front door, like a locked screen door or a security chain guard. If you are having trouble keeping track of your finances, hire a reputable fiduciary or professional to handle various aspects of your affairs.

If you have lost money in a scam, contact lawenforcement or call 1-800-510-2020


Por Denise Nelesen,Countys Aging & Independence Services

The UCSD Department of Psychiatry is recruiting for an NationalInstitutes of Health-funded study focusing on older adults whoare caring for a spouse with Alzheimers disease or otherdementia. Participants must be 55 or older. The study visitsare conducted in participants homes. Participants will receivefree counseling and lab results. For details, contact thecoordinator at (858) 534-9479.

UCSD Seeks Dementia Caregivers

A series of live streamingseminars about caring forloved ones are offered free bythe San Diego CaregiverCoalition at noon on selectedFridays. These webinarsbenefit adult children of agingparents, caregiving spousesand professionals in the fieldof health and aging. Eachinteractive seminar lasts halfan hour. All you need isInternetand email. Visit:caregivercoalitionsd.org,or for questions, email to:[email protected].

Cool Zone 2015Are you providing care

to a love one?

SDG&E warns about

utility scammers

Imposters posing as SanDiego Gas & Electricemployees have beentalking their way into homesso they can burglarize them.

Cool Zones are air-conditioned sites, such aslibraries and communitycenters, where older adultsand others can go to cool offand save the cost of usingtheir energy at home.

The County has designatedmore than 100 Cool Zonesites in the hottest areas ofthe county. Look for the CoolZone bear logo on theirwindows. To find a site nearyou, go to CoolZones.org orcall (800) 510-2020 andpress 6.

28

"Customer safety is a top priority andSDG&E is working to make surecustomers are equipped with the tipsto help them properly identify a SDG&Eemployee or contractor at any time,"according to a company statement.

Those tips include checking that theperson has a properly SDG&E-markeduniform and identification badge, andthat they are driving an officialcompany vehicle. Also, SDG&E wantscustomers to know none of itsemployees will ever ask customers toleave their home while service is beingperformed.

"If you are suspicious, please callSDG&E at (800) 411-7343 to ensurethat work currently is being conductedin your area," the utility said.

Live better, healthier and

stronger! Sign Up for

"Healthier Living"

Classes!

The County of San Diego iscoordinating interactive and goaloriented workshops called HealthierLiving. The workshops are held oncea week for people with chronic healthconditions such as arthritis,depression, heart disease, diabetes,COPD, or any chronic il lness.Caregivers are also welcome toattend.

Designed at Stanford University thisprogram has been proven to achievepositive health outcomes and reducedhealth care expenditures. Topicsinclude diet, exercise, medicationmanagement, cognitive symptommanagement, problem solving,relaxation, communication with

Apply for Veterans

Benefits at Library

Four East County librariesare now sites for veterans toapply for benefits.Call theVeterans Service Office toschedule: (858) 694-3222(from 8 a.m. to 5 p.m.).


Join a Feeling Fit Club!

You can be part of theFeeling Fit phenomenon!The clubs offer socialinteraction and build self-esteem in a relaxed, non-threatening environment.Participants say they havebetter balance, greaterstrength and flexibility,enhanced sleep, improvedmood, better digestion,more relief from arthritisand more resistance tochronic illnesses. To join aclass near you, call (858)495-5500, ext. 3 and leaveyour name, number andaddress.

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SCAM ALERT: Dont Fall

for Fake Background

Check Emails

The District Attorneys Officeis warning residents of SanDiego about a nationwideonline scam where emailsare sent to individualsadvising that a backgroundcheck has been performedon them. While its humannature to be curious aboutwho and why someonewould run a backgroundcheck, the email is notcoming from a trustedsource and you should notclick on any links. Doing somay install malware on yourcomputer, and/or provide thesender with your entirecontact list, turning you intoan unwilling spammer.

It is very unlikely thatsomeone has just performeda background check on you.When law enforcement andprivate investigativeagencies conductbackground checks thereare no notifications sent out.If you or someone you knowreceives this email or onelike it, do NOT CLICK on thelink. Doing so may releasemalware on your computer.Instead DELETE the email.

Make a difference inyoung lives. In the Five &Fit program, older adults(age 55+) guide youngpre-schoolers (ages 2 - 5)and their families towardimproved nutrition andenhanced physicalactivity. Activities includegardening, tasting fruitsand vegetables, and funnutritional education. Themission of the program isto prevent childhoodobesity and to promotehealthy, active, life-longbehaviors. Programs inEast and South San DiegoCounty are looking for newvolunteers . If you areinterested, please contactPam Plimpton at:[email protected] 858.495.5769

Share your love of

healthy living!

healthcare providers, anddealing with difficultemotions. The HealthierLiving workshops areavailable at sites throughoutthe County.

Registration for the Take Me Homeprogram is now available online! Take MeHome (TMH) is a local registrycreated by the San Diego SheriffsDepartment and used by law enforcement allover San Diego County. TMH uses facial rec-ognition technology to help identify and safelyreturn home those who may wander or be-come missing, and are unable to identifythemselves or where they live. We encour-age you to register your child or family mem-ber (if appropriate) today.

Registration and more information:

Registration for the Take Me Home

program is now available online!

If this program wasnt in place, I dont feel Icould go anywhere, Ben says.

Donna assists another family where the wifehas not been able to work for the past sevenyears because of the care her husband needs.The woman is relieved that through SD-VISAshe is finally able to have employment andpay into Social Security.

Veterans who feel they might be eligible forSD-VISA should talk with their VA social work-ers, according to Donna.

Ben says its worth the effort: Donna hasbeen very, very helpful. Theres so much outthere that people dont know about. You haveto keep asking and looking and youll findsomething that fits. the caregiving journeyto navigating the twists in a labyrinth, and em-phasizes that there is life after caregiving.

Veterans Benefit from...

www.sdsheriff.net

CONTINUED from PAGE 23


portrayed in the film are done fordramatic effect and are inaccurate.For example, a tsunami does nothave a crest and the water levelsdo not stay in place upon arrival.

6. When the ground starts toshake, in the film, the seismologistplayed by Paul Giamatti makes theideal public service announce-ment: 'Drop, cover and hold on.'Here the movie San Andreasserved as a good reminder for allto make sure you are prepared,practiced and registered for#ShakeOut.

Everybody can and should partici-pate in a drill or trainings with asimple Drop, Cover, and Hold. Be-cause, drills, exercises, andtrainings are key tools that help thebrain acquire skills that enable in-dividuals to better overcome shockand support crisis response. Youcan practice what to do in avariety of situations, conduct anevacuation, and more!

In 2009 there was a KPBSprogram about participating andpracticing during The ShakeOutDrill in San Diego. The programends with a message from DaveDalton, who was SecurityDirector at San Diego NaturalHistory Museum. What he saidat the end of the program wassomething that works to be repeatand published for publicawareness and public educationfor disaster risk reduction.

"The real important message thatits been sort of alluded to but wereally need to make this messagestrongly. People in general, noteveryone, but in general peoplebelieve that the troops are goingto be there to come to your

FICTION or REALITY?

CONTINUED FROM PAGE 3

30

rescue following an event like this.That is just simply not the case.I spent 29 years in law enforce-ment as a first responder to everykind of disaster almost you canthink of including earthquakes,and I can tell you that immediatelyemergency services areoverwhelmed, inundated, and theyhave to prioritize. Where thegreatest need is, is where thoseresources are going to be sent andpeople really have to gear theirthinking, planning and preparationto be on their own, and thatincludes attending to theirmedical needs, medications thatthey may need, glasses that maybe broken that they dont havean extra pair of, providingfor theirelderly, handicappedindividuals, and pets, animals thatthey may have, these all factor intovery specific plans that they mustaddress now because they aregoing to be on their own fora period of time in any majordisaster. If we have that 7.8 earth-quake, they are going to be onyour own for 3 to 5 days."

In the reality, it takes all of usworking together to effectivelyprepare for, respond to, andrecover from emergencies anddisasters. There are simpleactions we all should do to getprepared to survive and recover.

1-Be prepared, being preparedfor disasters is a sharedresponsibility. When peopleprepare and practice for anemergency prior to the disasterevent, it enables them to surviveand recover quicker.

2 - Be informed on what to dobefore, during and after. It makesa real difference in peoples abilityto take immediate and informedaction.

3-Participe in drills and practices.

Participation in group discussions,drills, exercises, and trainings helpto establish brain patterns thatsupport quick and effective actionduring an emergency.

An excellent way to practicehow to survive an earthquake isto participate in The GreatShakeOut.

It takes 1 minute to practice! Forthis year, most ShakeOut drills arescheduled for 10:15 a.m. on Oc-tober 15.

Wherever you areat home, atwork, at school, anywhereyoushould Drop, Cover, and HoldOn as if there was a majorearthquake occurring at that verymoment, and stay in this positionfor at least 60 seconds. Everyoneis encouraged to participate.Learn more at: ShakeOut.org

For more information please visit:

earthquakecountry.org to learnmore, and to find some online briefanimations adapted from the origi-nal Seven Steps to EarthquakeSafety.

To learn more about AmericasPrepareAthon!, and how you canplay a role in your communityspreparedness, visit: ready.gov

You can also contact the County ofSan Diego Office of EmergencyServices for questions and moreinformation at:[email protected]

This document includes Key Messagesuggestions from the following agencies:

o Southern California EarthquakeCenter/Earthquake Country Alliance(SCEC/ECA)o US Geological Survey/CaliforniaGeological Survey (USGS/CGS)o California Governors Office ofEmergency Services (Cal OES)o FEMA/ready.gov


NDEP is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and privateorganizations.You should consult with a healthcare professional before starting any diet, exercise, or supplementation program, before taking anymedication, or if you have or suspect you might have a health problem.

RECOGNIZING THE SYMPTOMS

Hypoglycemia, also called low blood glucose orlow blood sugar, usually feels like theres nocontrol of the body and its difficult to figure outwhat is happening and why. Sometimes therollercoster of feelings that a person with low bloodsugar has is difficult to understand.

You may have briefly felt the effects of low bloodsugar when you've gotten really hungry orexercised hard without eating enough. Thishappens to nearly everyone from time to time.

Low blood sugar can happen suddenly. Usuallythe body will send warning signs when blood sugarlevels start to drop. This is usually mild and canbe treated quickly and easily. If left untreated,blood sugar levels may continue to drop, andcan get worse. When it becomes severe,hypoglycemia can lead to cause accidents,injuries, coma, and death.

Continued from page 21

Hypoglycemia

31

Low blood sugar- hypoglycemia- occurswhen something disrupts the balancebetween food, exercise and medications.

EXAMPLES OF THIS ARE:

levels. This occurs when nicotine withdrawalincreases stress levels and releases ahormone called adrenaline. Hypoglycemia can also result from othermedications or diseases, hormone or en-zyme deficiencies, or tumors.

Eating too little or at the wrong time, such asrunning late for lunch or being caught in traffic. Exercising extra hard or doing chores, such asyard work , or having a extra-long practice, gameor unusual activities A sudden stressful situation such as having anaccident, or too many personal problems thatcannot be solved. Taking too much insulin, due to misjudging theamount needed Drinking alcohol without food. Alcohol lowersblood sugar and can also have affects when itsmixed with medications Smoking cigarettes raises blood sugar

Continued >

If you experience any of the simptoms listed onpage 21 check your blood sugar level right away.If the test result is less than 70 mg/dl, yourblood sugar is low or is dropping.

Severe hypoglycemia, or diabetic shock, is a se-rious health risk. It is a medical emergency.

If you do not have a meter to check your sugarlevel, but you have the symptoms, go ahead andtreat the reaction immediately by eating foodsthat can raise your blood sugar quickly.

Glucose, an important source of energy for thebody, comes from food. Carbohydrates are themain dietary source of glucose. Rice, potatoes,bread, tortillas, cereal, milk, fruit, and sweets areall carbohydrate-rich foods.


Re-test your blood sugar level in 15 minutes.If the result is still below 70 mg/dl, or if youstill have symptoms, repeat treatment. If theblood sugar goes over 70 mg/dl on re-test,but the next meal or snack is within an hour,eat a small snack such as:

The following foods will provide about15 grams of fast-acting carbohydrates. 1/2 cup of fruit juice 4-5 hard candies 1/2 cup of regular -no diet- soda 6-7 lifesavers 4 glucose tablets 1 small box of raisins 1 tube of instant glucose

6 crackers and 1 ounce of cheese 1 cup of milk 3 graham crackers and1 tablespoon of peanut butter 1/2 sandwich

Be aware that candy bars, ice creamand chocolate are not good choices offoods to treat low blood glucose reac-tions. They contain fat that will slow therelease of glucose and will not raise thesugar in the blood fast enough.

Hypoglycemia is particularly dangerous if ithappens to someone who is driving. People withhypoglycemia may have trouble concentrating orseeing clearly behind the wheel and may not beable to react quickly to road hazards or to theactions of other drivers. To prevent problems,people at risk for hypoglycemia should check theirblood glucose level before driving. During longertrips, they should check their blood glucose levelfrequently and eat snacks as needed to keep thelevel at 70 mg/dL or above. If necessary, theyshould stop for treatment and then make sure theirblood glucose level is 70 mg/dL or above beforestarting to drive again.

Remember

How to treat a low bloodsugar reaction

32

People who experience hypoglycemia severaltimes in a week should call their health careprovider.

Some people may start to have symptoms ofhypoglycemia when their blood glucose levelsare very high and start to go dow

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