Monday, December 21, 2015

Merry Christmas and A Prayer for Love, Forgiveness, and Hope

            The Christmas Holiday Season is upon us and represents a very important day for Christians all across the planet. This season brings an opportunity to stop, reflect, and to heal. Regardless of belief system or background, all humans benefit from feeling and expressing love, forgiveness, and hope.

            Today, we are a nation in need of healing in many ways. We seem to be split on too many factors from politics, socioeconomic structure, religion, race, gender, etc. Our days are spent engaged in hurtful and harmful behavior, judgment, and gossip towards one another. We seem to have lost a sense of grace, kindness, and compassion and we might need to be reminded that we are all humans with so much in common.

            It is not difficult to turn the television on and witness much violence, hatred, and killing across the world. Once again, humans with so much in common have instead turned to rage and hatred that splits us and keeps us from the greatness the human race can and should be.

            We often turn to political leaders to resolve such issues and we might believe there are laws that can fix the problems we face. While that will continue to be a strategy worldwide, I think Christmas offers another strategy, one that is much more human and indeed real.

            My prayer for this Christmas and Holiday Season is for all Americans and indeed all humans on planet earth to turn to the greatest healing medicines of all time: Love, Forgiveness, and Hope. Let us work to express our love for one another, to forgive those who have hurt us, and to offer hope to those in need.

            It is very true that there are those in our world who will not join me in this prayer. However, there are millions of us on this planet who are filled with Love, Forgiveness, and Hope and together we can unite our nation and world for a better tomorrow.

            Jesus taught us to love others, as we want to be loved, to forgive those who trespass against us, and to always have hope. We are meant to help others and to be compassionate to those most in need. We are to free ourselves from angst and bitterness and all anxiety. Each of us has this power within and it really is the best path to our healing and feeling whole as a world again.

            Join me this Christmas and Holiday Season in prayer for and expression of Love, Forgiveness, and Hope!

God Bless Everyone,

Dr. Nussbaum

Wednesday, November 18, 2015

Money and Dementia: A Crisis Starting to Happen

It seems that there is always a looming catastrophe on the horizon as the huge group of boomers move toward their senior years.  With boomers turning 65 at a rate of 10,000 per day and this phenomenon continuing until 2030, any problem skyrockets into a catastrophe.  Add to the vast number of boomers becoming seniors, the fact that $42 trillion (yes, that’s a T) worth of assets rests in their hands and the hands of their parents.  Now as wealth and large groups of seniors converge, stir in the projected incidence of dementia and you now have a picture of an impending crisis.

Let’s step back from the ledge for a moment and get down to the individual impact memory loss has on financial competency.  There are normal declines that occur to the brain as we age.  Problem solving skills diminish with age; memory, analytical reasoning and processing speed decline with age.  Reasoning skills actually drop steadily after a peak at age 53.  Finally aging erodes financial acumen resulting in mistakes with credit cards, home-equity loans, and how to pay for healthcare.

The ability to take care of our finances is termed financial capacity which includes routine tasks like basic monetary skills, carrying out cash transactions, managing a checkbook. bank statement, and exercising financial judgment.  Financial literacy takes financial knowledge a little farther.  Concepts of investing and inflation are part of the landscape of financial literacy.  And guess what – financial literacy decreases with age.  Older investors are less effective in applying their investment knowledge and demonstrated worse investment skill. 

Everything I just described occurs with normal aging and sustaining these types of losses puts older people at a greater risk for frauds and scams. 

Now let’s look at the financial abilities of someone who is cognitively impaired (e.g. Alzheimer’s disease).  Diminished financial capacity becomes apparent when it becomes difficult to identify and count money, understand debt and loans, conduct cash transactions, and pay bills– the most basic of financial skills.  Financial capacity is one of the first abilities to decline with the onset of cognitive impairment.  These declining skills are apparent even before a diagnosis of dementia is made.  Loss of financial skills is a dilemma for this group because in all other aspects of their lives they may appear to be performing normally.  So how are these people found out?  This might be the first indication to family members that there is a problem.  They stop in to say hi and see a pile of unpaid bills sitting on the desk.  They could notice receipts for outrageous purchases.  And they are usually met with resistance when asking about these issues because there is so much fear on the part of their loved one that they will lose financial autonomy.  Even though they are clearly not able to take care of their financial responsibilities, they don’t understand why this is a problem that needs to be attended to.

There are six warning signs of diminished financial capacity:
1.     Memory lapses: bill paying is dependent on memory – forgetting to pay a bill or repeatedly paying the same bill; multiple trips to the ATM or the bank to withdraw money; errors in check writing
2.     Disorganization:  handling bills, keeping track of finances, managing important financial documents – actions that are difficult to perform because there is so much disorganization of paperwork
3.     Decline in checkbook management skills:  this is one of the very first skills to decline; requires procedural skills which are dependent on executive abilities of the brain
4.     Arithmetic mistakes:  decline in both written and oral arithmetic skills
5.     Conceptual confusion:  new difficulty understanding financial terms and concepts
6.     Impaired judgment:  new interest in get rich quick schemes; change in risk preference regarding investment decisions; new found enthusiasm for questionable investments; new reports of erratic, unusual, or uncharacteristic purchases, withdrawals, or gifts.; with poor judgment comes the risk of succumbing to telephone, mail, and internet schemes; problem with impulsivity leading to gambling and overspending.

The inability to handle financial decisions puts this group at high risk for exploitation and abuse. This group possesses a large portion of our nation’s wealth.  A 2011 Metlife Mature Market study found older adults lose $2.9 billion annually.  1 in 10 adults is a victim of mistreatment.  5.2% experience financial mistreatment by a family member.  Of all forms of elder abuse, the highest rate of mistreatment was major financial exploitation.  Bringing this tragedy home was the appearance of Micky Rooney before Congress.  He testified how his family had mistreated him and exploited his finances.  This is a cold, heartless act of abuse.

Are there any solutions emerging for this impending crisis?  The financial industry is taking steps to put safeguards in place to protect their older clients.  The Financial Industry Regulatory Authority reported that some financial firms are including paperwork to access referrals to relatives, or others in the event that signs of diminished capacity surface with their client.  Wells Fargo Advisors launched an Elder Client Initiatives team to answer questions from their advisors around the country on how to handle cases of possible dementia.  AARP is working with the American Bankers Association Foundation on education materials for consumers, financial caregivers and bankers on age-friendly banking -> how to address dementia, fraud, and financial caregiving.

This educational push is critical to alert bankers, financial planners, and families on recognizing signs of dementia and appropriate steps to safeguard assets of clients and family members.  These solutions and safeguards need to be in place as soon as possible because this problem grows bigger by the day.

´  Ambrose,E. (October, 2015). Money and memory: a coming crisis. AARP Bulletin/Real Possibilities.
´ Financial Capacity and Competency in an Aging America. (Summer, 2012). Generations 36(2). Published by the American Society on Aging. 71 Stevenson Street, Suite 1450, San Francisco, CA 94105-2938.

´ Ross,V. (Nov. 18, 2010). Older but not wiser? The psychology behind seniors’ susceptibility to scams. Retrieved September 4, 2015 from

Saturday, November 7, 2015

Power of Thank You

Thank You

Two simple words that can make a difference. By saying Thank You it indicates you are appreciative of someone for something they did. It also means that there is someone in your life who has done a good deed or said something nice to you. It seems to me that as difficult as our world can be at times these two words might help to make our lives just a little bit better.

In the near future we will celebrate a holiday known as Thanksgiving. This holiday has historical import for our nation and it also provides an annual opportunity for all of us to stop, reflect, and to give Thanks.

Families will gather, friends will unite, and a celebration of unity and food will mark a day for expression of love, humility, and indeed Thanks. The most precious gifts we have do not come in boxes or bags. Rather, family members who may be with you in person or in spirit represent what is most important. It is good to share a smile, tell each and everyone that you love them, and just hold on to a hug for an extra moment as you smile and feel the spiritual connection that love brings.

For some, this holiday might spark tension and offer the opportunity to think about small battles that might be present between family members. I encourage all to use the Holiday as a time to heal, to share love, and to express Thanks. Do so with those where some tension exists and you will feel the healing power of grace even more.

Happy Thanksgiving to you and please take a moment to be with those who mean so much to you. Regardless of our particular situation, we have much to be thankful.

Dr. Nussbaum

Wednesday, October 28, 2015

Patience Really is a Virtue:

Most of us feel a bit rushed now and then. Most of what we need yesterday is not worth the angst that fills our body and brain. A deep breath and reconnection with the big picture can help in such situations. In general, slow your life down and work on the virtue of patience.
Dr. N.

Tuesday, October 20, 2015

Laugh and Let Go

Try to laugh a bit more in your life as it a wonderful medicine that carries healthy neurochemicals and hormones throughout your brain and body!

Tuesday, October 13, 2015

Love of Self

The origins of all health, happiness, and purpose come from within as provided from above. Begin today by giving yourself some love and kindness. 

Dr. Nussbaum

Wednesday, September 30, 2015

The Power of a Smile

The Power of a Smile

Close your eyes and open your arms wide in front of you. Now smile and hold the smile for a few seconds in silence. How does your body and spirit feel? Next, open your eyes and bring your arms in close to your body and hug your body tight. How do you feel? Finally, open your arms and close your eyes again and create a big smile. How do you feel...any different from the closed position when you hug your body with your arms?

Being open with a smile is a direct way you can feel better, happier, and at ease! Give it a chance several times a day.

Smiling is a great medicine.

Dr. Nussbaum

Tuesday, September 15, 2015

The Special Qualities of a Caregiver

The Role of Caregiver

            There really is not a textbook, no blueprint, and no guide on how to be a caregiver. This is true despite the fact that for Alzheimer’s disease alone, there are nearly 15 million caregivers and that number will rise dramatically in the next 25 years. Consider all the caregivers for loved ones suffering the different forms of illness and it is easy to appreciate how important the role of caregiver is in our society.

            It is true that caregivers are a special group. They are patient, compassionate, caring people who place the needs of others in front of their own. We all agree that these are highly admirable qualities, but it is also true that over time such qualities can be detrimental to one’s own health. It is indeed common for caregivers to be so focused on their role of caring for another that their own health and wellbeing gets neglected. We know that at least 33% of caregivers suffer depression, while others experience sleep disorder, anxiety, lost wages and reduced time spent at work.

            Caregivers are human beings and it is normal for feelings of guilt, irritability, frustration, resentment, and even anger to creep into their day as the pressure and time demands inherent on caregiving increase. Perhaps, a guide or a class on caregiving could be required prior to our graduation from high school! Not a bad thought, but I tend to think we are all born with the natural characteristics of caregiving and that some of us actually express this beautiful talent, this form of loving-kindness.

            I have spent nearly 30 years caring for those with Alzheimer’s disease and for each person who struggles with this disease there are two or more family members or friends who surround their loved one with support and hope. I have watched with great admiration the sweet and patient care granted by the caregivers and it has been a constant reminder of the goodness that we humans have.

            To all the caregivers who read this blog, God bless you and know that you represent the best of humanity. Continue to love, since love is the best medicine, and please take some time for your own needs.

Dr. Nussbaum

Wednesday, August 5, 2015

Prescribing Exercise

            Like many who are interested in health, I have been an outspoken champion on the benefits of movement, physical activity, and exercise. For me, the importance of exercise is directly linked to brain health in the form of learning, mood, energy, and esteem. I also appreciate that exercise helps nearly all parts of the body such as the heart, bones, joints, muscles, and digestion.

            Research has been quite robust on the benefits of regular exercise and health. Scholars such as Charles Hillman and Kirk Erickson have been leaders in demonstrating the benefits of physical activity to our structural and functional brains and bodies. Now, a new article written by Dr. Hausenblas and published in US. News (8-5-15) raises the question I too have been asking for years, “Why don’t physicians prescribe exercise?”

            The article underscores the fact that exercise is one behavior, one intervention and indeed prescription that significantly impacts our overall health. The science is clear as noted above in that exercise is not only preventative, but it can also help treat chronic conditions such as coronary heart disease, diabetes, hypertension and depression. I would also include anxiety with this list and there are still others such as cognitive problems. Research indicates that people who exercise regularly can expect to live an average of seven years longer those who are inactive.

            A new initiative called Exercise is Medicine ® focuses on encouraging health care providers to include physical activity when creating treatment plans their patients. A key component to this program is to have all health care providers assess their patient’s physical activity at every visit. Physical activity should be recorded as a vital sign during patient visits and to encourage able patients to meet physical activity guidelines.

            Research published in the Journal of Physical Activity and Health indicates that more than 50% of the physicians trained in the U.S. in 2013 received no formal education in physical activity, and that they are not prepared to help their patients with their exercise plan. Dr. Bob Sallis suggested exercise be listed in the Physician’s Desk Reference as it is probably the most powerful drug available.

            The Mayo Clinic noted that nearly 70% of Americans take at least one prescribed medication costing us $374 billion in 2014. We are a nation reliant on medication and a culture in search of a quick fix. Perhaps exercise can begin to be presented as a medicine and we can continue to educate all ages of the benefits of exercise and physical activity to our health and happiness.