Music and Aging

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Many of us listen to music as a way to relax and unwind.  Now research shows that music may also offer health benefits. Recent studies have shown that music may protect again memory loss and cognitive decline, and also improve blood pressure, heart and breathing rate, and even muscle tone!  In addition, music may preserve our ability to discern between sounds, which is crucial to understanding and participating in conversation. 

Playing musical instruments may also offer benefits beyond simple enjoyment and creative expression.  One research study found that adults aged 60 to 85 who received piano lessons showed significant improvements in memory, verbal fluency, speed of processing information, and other cognitive functions. So, pull out those old instruments, pick up a new one, or go to a live music event to start exercising your mind- it will thank you in the years to come!

New free questionnaires can improve the care and quality of life of older adults in assisted living through person-centered practices

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New questionnaires are now available to help assisted living providers benchmark and monitor their person-centered practices.  Use of these questionnaires can improve the care and quality of life of the 733,000 older adults who live in assisted living residences across the country. 

The Toolkit for Person-Centeredness in Assisted Living was developed through a close partnership between the University of North Carolina at Chapel Hill and the national Center for Excellence in Assisted Living (CEAL), along with assisted living providers, residents, family members, and organizational representatives.  Available for free download, the Toolkit includes questionnaires to be completed by assisted living residents and staff, and simple, easy-to-follow instructions for scoring and interpreting the results.  The questionnaires measure Person-Centered Practices in Assisted Living, and are called the PC-PAL.  

Unlike other questionnaires that often are used, the PC-PAL questionnaires are based on research evidence and have been rigorously tested for ease of use and statistical validity.  

“Everyone involved in assisted living – residents, family members, staff, organizational members – wants care to be individualized, but there hasn’t been a way to measure these practices and identify areas that are either especially strong or need improvement.  Now there is,” said Sheryl Zimmerman, Ph.D., who led the university research team.

Zimmerman also noted that the involvement of a range of stakeholders in the developmental process assured that the questionnaires are relevant to and feasible for use by the people living and working in assisted living communities.

“A key mission of the Center for Excellence in Assisted Living is to promote research and distribute resources to support quality practices in assisted living.  The PC-PAL is an important tool that furthers our goal” said Robert Jenkens, Senior Vice President, National Cooperative Bank, and Chairman of the Board, CEAL.

He added that the PC-PAL is especially timely, considering that the Affordable Care Act and Centers for Medicare and Medicaid Services require assisted living to be person-centered.

“Using this questionnaire will help providers be more intentional in their care and focused on person-centered care and practices” emphasized Walter Coffey, a former assisted living administrator and current President of LeadingAge Georgia, who participated in the development of the PC-PAL.  “It’s simple, and can help provide care that truly meets the preferences of assisted living residents.”

The PC-PAL and Toolkit are available at and

The Program on Aging, Disability, and Long-Term Care of the Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, aims to better understand and improve the well-being of older persons and the quality of care they receive.  For more information on the Program’s recent news and products,  visit the Sheps Center website at or contact Lauren Cohen, Associate Director, Collaborative Studies of Long-term Care, at 919-843-8874 or

CEAL members collaborate to promote excellence in assisted living through practice, public policy, technical expertise and research.  Members are AARP, Alzheimer's Association, American Assisted Living Nurses Association, American Seniors Housing Association, Assisted Living Federation of America, CCAL-Advancing Person-Centered Living, LeadingAge, National Center for Assisted Living, The National Cooperative Bank, Paralyzed Veterans of America and Pioneer Network.  For more information on CEAL's mission and members, visit CEAL's website at www.theceal.orgFor more information about CEAL, contact Diane Doumas, CEAL Executive Director, at 703-888-9557 or

Assisted Living Comparison Experts website featured as UNC’s Spotlight Story

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The Assisted Living Comparison Experts website is featured as UNC’s Spotlight Story.  Program on Aging, Disability, and Long-term Care co-directors Sheryl Zimmerman, PhD and Philip Sloane, MD, MPH were interviewed about their website, which provides information on all licensed adult and family care settings in North Carolina in a user-friendly format, and is designed to help consumers make the most informed choice when selecting a community.  Read the entire UNC Spotlight Story here

Healthy Eating during the Holiday Season

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As we prepare to enjoy the holidays with family and friends in the coming months, it’s likely that we’ll share in more than one hearty and potentially diet-busting meal.  WebMD reports that the average person will consume 4,500 calories and 229 grams of fat during Thanksgiving alone!  To put that into perspective, that’s the equivalent of eating almost 23 original glazed Krispy Kreme donuts, or 50 slices of bacon – at one sitting!

If that fact has you feeling a little uncomfortable, there are many ways to enjoy the festivities without having to worry about your waistline.  Here are a few easy tips for keeping the calories in check during the holidays:

1. Substitute, substitute, substitute.
Substitute butter and other fats with low-calorie choices. To replace sugar, try fruits like non-sweetened applesauce, mashed yams, or natural replacements like stevia. Is salt a problem? Add more non-salt seasoning blends to a dish, or add more fragrant herbs such as rosemary and thyme.

2. Don’t forget fruits and veggies.
Fill up on the fiber. You will feel fuller longer, and will be less likely to indulge in simple sugars, the kind that adds inches to your waistline.

3. Drink a lot of water.
It’s recommended that an average person drink half their body weight in ounces of water a day. For example, a 150-pound woman should drink at least 75 ounces of water a day. Staying well-hydrated will help keep you from overeating.   

4. Skip the skin.
Although the crispy turkey skin is delicious, it’s also full of saturated fat.  Eat the white meat and avoid the skin to save calories and fat.

5. Consider increasing protein.
Protein keeps most of us feeling fuller longer. Lean meats, seafood, and dairy may be good alternatives to simple carbohydrates (like white bread and white potatoes, for example). Increasing protein consumption may reduce sugar spikes and cravings for foods that only provide temporary satiation.

Care Managers: What Do They Do and How Can I Find One?

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Care managers are specially trained professionals who work with individuals and families to assess challenges a person is experiencing, listen to their concerns, and help problem-solve.  Assessment, planning, organizing, and monitoring are the four main roles of a care manager.Care managers are often social workers or nurses.  They work with many types of individuals, and some have specialized training to work with select types of people in particular.  Geriatric care managers, for example, work mainly with older adults or their families.

To find a care manager, contact the county departments of social services and ask for a referral. Another good option is to contact one or more national agencies that certify care managers, such as the National Association of Professional Geriatric Care Managers (NAPGCM) ( This organization provides a directory of certified care managers who assist older adults and their families. The NAPGCM recommends asking prospective care managers important questions including:  Are you licensed in your profession? Are you available for emergencies? and What are your fees?

In case you’re wondering whether a care manager might be right for you, here are a few scenarios in which care managers are useful: 

  • Emma, an 89-year old widow, lives alone in her home. Her daughter and son live several towns away, and both adult children have families of their own and careers that occupy most of their time. Emma recently became more forgetful and has left the stove on in her kitchen on more than one occasion. Her daughter is concerned, and when she calls Emma to remind her to check the stove, Emma gets frustrated and tells her: “You don’t have to talk to me like I’m your child!” Emma’s daughter doesn’t know what to do about her mom’s safety.
  • George is a 75-year old veteran with Parkinson’s disease. His wife died many years ago, and he has been seeing a woman he met in church. Friends notice that George is increasingly withdrawn and not as social as he once was. He spends many days at home, and doesn’t answer their phone calls. The only person who seems to keep in regular communication with him is his female friend. She’s also concerned because George “doesn’t seem as happy as he was” when they first met. George’s friends think he may still mourning the loss of his wife but they’re not sure.

Care managers can help in these situations, and might be able to help in yours.  Overall, it is important to find the right care manager for your situation, as well as one with whom you feel comfortable, who fits your budget, and can understand your needs. 

Computer Tablets Popular Among Older Adults

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There are an increasing number of tablets available on the market, and these differ widely.   So, how do you decide which tablet to choose?  The answer is that it depends on what you want to do with your tablet.  Do you just want to read e-books?  Or, do you want to check email and surf the web?  Or do you want to take and catalog photos? Below we discuss characteristics of tablets so that you can make the decision that’s right for you.  

The size of tablets varies from 7 inches (about the size of a large greeting card) to 11 inches (a sheet of paper).   Generally, tablets are less than a ½ inch in thickness.  In choosing your tablet, you should consider if you want to carry it around with you (meaning you might want a smaller one that fits in a purse or glove compartment) or if you want to leave it on your nightstand (meaning it can be larger).   Tablets have touchscreen keypads, but offer accessories including optional wireless keyboards, carrying cases, and covers.

Tablets are available in 8 GB, 16 GB, and 32 GB varieties. If you are going to spend a lot of time on the web, or anticipate multi-tasking with your tablet, you should consider a larger GB version, like the 16 or 32GB.  

There are a wide variety of apps available for tablets.  Popular apps include games (either played alone or with friends), organizational assistants (such as for store reward cards, photographs, and more), maps and GPS, and many others.  Although thousands of apps are free, users may pay from cents to several dollars for others.

Cameras in tablets can be in the back of the device for taking photos, or in the front for video conferencing and chatting online. For example, users can video chat using Skype or, for Apple users, FaceTime, with a front-facing camera.  Tablets may have one or both cameras installed. The range of megapixel quality varies from a low 1 megapixel to a high 8 megapixel.  If you plan to use your tablet to take photos, you should aim for a high megapixel camera.

Recent J.D. Power consumer rankings indicate that Samsung tablets are the most popular and preferred, closely followed by Apple and Amazon Kindle. The Samsung Galaxy tablets are available in 8 GB, 16 GB, or 32 GB.

It should be expected that tablets range in price based on their GB size. Tablets start in the range of $150 and can exceed $700. Among the least expensive tablets there is good variety, and users can select from products such as the Hicense Sero ($99), Asus ($129), Acer ($177), and Nexus 7 with 16 GB ($229). Some of the most expensive tablets are the Sony Vaio Tap 11 ($950+), Panasonic Toughpad (16 GB Android; $1500+), and HP Slate 2 (64 GB Android; $1600+). In the middle of the pack, are the ubiquitous iPads that range from $299 to $929.

Public reporting recommendations issued by national experts

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New recommendations have been issued by key stakeholders regarding the future of public reporting for assisted living and similar non-nursing home residential care.

The types of services, costs, and quality of care offered by assisted living residences vary widely, but little public information comparing residences is available for consumers.  Public reporting is one option for providing consumers, their families, and others, with objective information to compare the 31,000 assisted living residences across the country.  Currently, only a handful of states require providers to compile information about their services, and even then it is not usually readily available.  “Older Americans and their families need consumer friendly information to determine which residential setting best meets their priorities and needs,” said D.E.B. Potter, Project Officer of the U.S.  Agency for Healthcare Research and Quality (AHRQ), which has promoted numerous efforts related to assisted living/residential care and public reporting.

Forty organizational leaders in long-term care convened in a day-long meeting funded by AHRQ and supported by LeadingAge.  Representatives included those from the federal and state governments, investment and trade groups, policy makers, health care providers, consumer advocates, educators, and researchers.  More than 80% of attendees believed that additional efforts should be directed toward obtaining, compiling, and disseminating information related to specific services and supports offered by residential care providers.  Recommendations were proposed by a majority of participants in three areas:    

1.  Utility of publicly-available information 

a.  Consumers want to be able to compare providers to guide their decision making.  Therefore, relevant information about specific services and supports should be made available to consumers in advance of selecting a residence.

b.  Beyond consumer education, publicly-available information could inform providers of the services that others offer and potentially motivate them to change or improve their services.  The information also could be useful to policymaker, regulators, researchers, and others.

2.  Content of publicly-available information 

a.  Consumers would benefit from information related to survey results, verified complaints, and outcomes such as satisfaction.   They and others would benefit to some extent from “report cards” or similar rating scales. 

b.  Medically-related outcome information would  be challenging to provide in a balanced manner due to variability in the residents who live in these settings, such as how they vary in their medical and functional needs.

c.  Some of the information that is relevant to consumers is subjective; consumer-provided ratings may best provide this type of individualized information.

3.  Roles and responsibilities related to obtaining and disseminating publicly-available information

a.  State mandates may be necessary in order to collect and report detailed information on all providers, because not all providers may want to share detailed information in advance of a consumer visiting their residence,  or to provide information to a central reporting source.

b.  Independent, reputable, unbiased organizations should be responsible for disseminating public information, which may be state governments or others.

“This conference provided the ‘next-steps’ agenda to compile and provide publicly-available information related to assisted living and other residential care.  The next step is to make relevant information available in an accessible and easy-to-use format, and to encourage consumers to share their assisted living experiences,” said Dr. Sheryl Zimmerman, Professor and Co-Director of the Program on Aging, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, who convened the conference. 

If you have questions or comments about this information, contact Lauren Cohen at (919-843-8874).